Tyra Jackson, FNP-BC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

209.033340 Issued in IL

Practice address

120 N Oak St
Hinsdale, IL 60521-3829

Phone

(630) 856-6825

NPI assigned

Dec 4, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicagoland Pain Management Institute IncGroup PAC ID 1850536830, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
• Uchicago Medicine Adventhealth la Grange Hospital, La Grange, IL, CCN 140065
• Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13549/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chicagoland Pain Management Institute, Inc.

  • Pain Medicine Physician
  • Bolingbrook, IL
  • NPI 1801146303
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Bolingbrook Hospital

  dba Adventhealth Bolingbrook

  • General Acute Care Hospital
  • Bolingbrook, IL
  • NPI 1164530465
  Care Compare affiliation
• Adventist Midwest Health

  • General Acute Care Hospital
  • Hinsdale, IL
  • NPI 1265465439
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • General Acute Care Hospital
  • La Grange, IL
  • NPI 1407889652
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth Hinsdale

  • Psychiatric Hospital Unit
  • Hinsdale, IL
  • NPI 1447270780
  Care Compare affiliation
• Adventist Midwest Health

  dba Adventhealth la Grange

  • Rehabilitation Hospital Unit
  • La Grange, IL
  • NPI 1588068274
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1154284453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S. SCHMIDT RD, SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-312-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213829",
            "telephone_number": "630-856-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TYRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "209.033340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Y Ito, MD
• Iveta Boyanchek MD SC
• Ronda Jaber
• Kinsey Meredith Jackson-Ford, CNM
• Alexis Jackson
• Renee H Jacobs, MD
• Mark C. Jacobson, M.D
• Neeraj Jain, M.D.
• Ayisha Jameel, MD
• Jana Bergfeld LCSW, P.C

• Interventional Pain Medicine Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.