Individual provider Active NPI

Michelle Jackowski, CNM

  • Advanced Practice Midwife
  • Elmhurst, IL
National Provider Identifier
1194039669
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
277001179 Issued in IL
Practice address
1200 S York St Ste 4120
Elmhurst, IL 60126-5630
Phone
(331) 221-9009
Fax
(331) 221-2750
NPI assigned
Jul 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209008236 IL
Advanced Practice Midwife 367A00000X 277001179 IL Primary

Addresses

Primary practice location

1200 S York St Ste 4120
Elmhurst, IL 60126-5630

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other names 1

  • Ms. Michelle Dougherty Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjackowski41763@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000276 IL Practitioner - Certified Nurse Midwife (CNM) 5597944892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1200 S York Rd
Suite 1120
Elmhurst, IL 60126-5626
Phone (630) 527-3200

1200 S York St
Elmhurst, IL 60126-5626
Phone (331) 221-6636

130 S Main St
Lombard, IL 60148-2670

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Elmhurst Memorial Healthcare CurrentSince Sep 1, 2013 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 10, 2024 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Sep 1, 2013 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 10, 2024 Accepting new patients
Marjorie Nolan Cohn LLC Past Accepting new patients
Wyse Eyecare SC Past Accepting new patients
Elmhurst Memorial Hospital PastSince Jun 22, 2021 Accepting new patients
Allara Medical Group PA Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1200 S York St
Ste 4120
Elmhurst, IL 60126
Phone (331) 221-9009

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

1200 S York St
Elmhurst, IL 60126
Phone (331) 221-5678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

4201 Winfield Rd
Fl 4
Warrenville, IL 60555

Interoperability endpoints

  • Direct secure messaging: mjackowski41763@direct.edward.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1194039669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 4120",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265630",
            "telephone_number": "331-221-9009",
            "fax_number": "331-221-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKOWSKI",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209008236",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "277001179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjackowski41763@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 S York St Ste 4120",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DOUGHERTY",
            "prefix": "MS.",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.