Lisa R. Jackson, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

309002626 Issued in IL

Practice address

22285 N Pepper Rd
Suite 401
Lake Barrington, IL 60010-2538

Phone

(847) 882-6604

Fax

(847) 882-6228

NPI assigned

Jun 14, 2006

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Neurology, LTDGroup PAC ID 8729069158, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Northwest Neurology, LTD

  • Neurology Physician
  • Lake Barrington, IL
  • NPI 1427094077
  Medicare reassignment Care Compare group NPD

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

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1316980766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD",
            "address_2": "SUITE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102538",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD",
            "address_2": "SUITE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102538",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LISA",
        "middle_name": "R.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "309002626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James David Hursey
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• Shahid B. Ilahi, M.D.
• Illinois Bone and Joint Institute, LLC
• Illinois Bone and Joint Institute, LLC
• Ambili Mariam Jacob
• Jill S Jacobek, R.PH.
• William Joseph Jedlicka, PHD
• Carolyn Lee Johnson, WHNP, APN
• Karen R Glay (Suburban Hearing Services)

• Nurse Practitioner in Lake Barrington, IL
• Providers in Lake Barrington, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.