Individual provider Active NPI

Jeffrey D. Ackman, M.D.

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1417063389
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036-066460 Issued in IL
Practice address
2211 N. Oak Park Avenue
Chicago, IL 60707-3392
Phone
(773) 385-5491
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036-066460 IL
Orthopaedic Surgery Physician 207X00000X 036-066460 IL Primary

Addresses

Primary practice location

2211 N. Oak Park Avenue
Chicago, IL 60707-3392

Mailing address

PO Box 8500, Lockbox 7642
Philadelphia, PA 19178-7642
Phone (813) 281-8115

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131021000104 IL Practitioner - Orthopedic Surgery 1658506068 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-066460ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Apr 22, 2021 Accepting new patients
Cook County Current Accepting new patients
Cook County Surgery CurrentSince Apr 22, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Nov 20, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 22, 2013 Accepting new patients
The Board of Trustees of the University of Illinois Orthopaedic Surgery CurrentSince Nov 20, 2017 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jul 22, 2013 Accepting new patients
Shriners Hospitals for Children Orthopaedic Surgery Past Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

901 S Wolcott Ave
Chicago, IL 60612
Phone (312) 996-3470

Interoperability endpoints

  • Direct secure messaging: jackman16821@uihealth.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1417063389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500, LOCKBOX 7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8115",
            "fax_number": "813-281-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N. OAK PARK AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073392",
            "telephone_number": "773-385-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKMAN",
        "first_name": "JEFFREY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-066460",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-066460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.