Active NPI
Jillian Lynn Smith, DO
- Family Medicine Physician
- Davenport, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO-55696
- Practice address
- 1345 W Central Park Ave
Davenport, IA 52804-1844 - Phone
- (563) 421-4400
- Fax
- (563) 421-4449
- NPI assigned
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.171216 | IL | |
| Family Medicine Physician | 207Q00000X | DO-55696 | IA | Primary |
| Family Medicine Physician | 207Q00000X | DR.0070775 | CO |
Addresses
Primary practice location
1345 W Central Park Ave
Davenport, IA 52804-1844
Mailing address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone (563) 421-4400
Other practice location 1
1820 W 3rd St
Davenport, IA 52802-1812
Phone (563) 421-0500
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 N River Rd
Des Plaines, IL 60016-1209
Phone (847) 297-1800
7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0070775 | CO | MD | Family Medicine Physician |
| 036.171216 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Healthcare Illinois Medical Group LLC | Family Medicine | Current | Accepting new patients |
| Presence Healthcare Services | Past | Accepting new patients | |
| Genesis Health System | Past | Accepting new patients |
Locations
1801 W Olympic Blvd
#2637
Pasadena, CA 91199
1801 W Olympic Blvd
#2636
Pasadena, CA 91199
1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756
100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780
7435 W Talcott Ave
Ste 182
Chicago, IL 60631
Phone (773) 792-5154
7447 W Talcott Ave
Ste 182
Chicago, IL 60631
Phone (773) 594-7875
100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800
201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Des Plaines, IL
- NPI 1023837689
Family Medicine
-
- Critical Access Hospital
- De Witt, IA
- NPI 1649368523
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1922115864
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1811735228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786579200000",
"number": "1558980185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1345 W CENTRAL PARK AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528041844",
"telephone_number": "563-421-4400",
"fax_number": "563-421-4449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 W CENTRAL PARK AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528041844",
"telephone_number": "563-421-4400",
"fax_number": "563-421-4449"
}
],
"practiceLocations": [
{
"address_1": "1820 W 3rd St",
"address_purpose": "LOCATION",
"city": "Davenport",
"state": "IA",
"postal_code": "528021812",
"country_code": "US",
"telephone_number": "563-421-0500",
"fax_number": "563-326-1901",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "JILLIAN",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-14",
"last_updated": "2026-08-13",
"certification_date": "2026-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036.171216",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "DO-55696",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "DR.0070775",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.