Robyn A Jackson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036095867 Issued in IL

Practice address

600 Holiday Dr
Suite 525
Matteson, IL 60443-2241

Phone

(708) 898-2613

NPI assigned

Jun 12, 2006

Last updated

Apr 25, 2016By the provider in NPPES

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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

• West Adams Health Services Inc.

  • Internal Medicine Physician
  • Matteson, IL
  • NPI 1356707640
  Authorized official Same address or phone
• Chicago Metropolitan Obstetricians Gynecologists and Pediatricians

  • Obstetrics & Gynecology Physician
  • Harvey, IL
  • NPI 1609216084
  NPD (past)
• Foot and Ankle Inc

  • Primary Podiatric Medicine Podiatrist
  • Homer Glen, IL
  • NPI 1679760821
  NPD (past)
• Forever Care Home Visiting Physicians Inc

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1851865364
  NPD (past)
• Home Visiting Physicians

  • Internal Medicine Physician
  • Palos Hills, IL
  • NPI 1487697496
  NPD (past)
• House Calls of Greater Chicagoland

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1285989160
  NPD (past)
• MD @ Home Illinois, SC

  dba Housecall Physicians of Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415
  NPD (past)
• Medical and Foot Care Group

  • Foot & Ankle Surgery Podiatrist
  • Palos HTS, IL
  • NPI 1114106457
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1346282449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOLIDAY DR",
            "address_2": "SUITE 525",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432241",
            "telephone_number": "708-898-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOLIDAY DR",
            "address_2": "SUITE 525",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432241",
            "telephone_number": "708-898-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ROBYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036095867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095867",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Jackson
• Jordyne Jackson
• Kayla Jackson
• Reginald P Jackson
• Robin Jackson
• Jasmine Perkins & Company LLC (Jasmine Perkins)
• Tamela S Jasper
• Christopher Jeffers
• Treacie Gill Jelks
• Brittney M Jeter, LPN

• Family Medicine Physician in Matteson, IL
• Providers in Matteson, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.