Individual provider Active NPI

Jaclyn Leigh Jeffries, APRN

  • Nurse Practitioner
  • Lisle, IL
National Provider Identifier
1649026683
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.028266 Issued in IL
Practice address
430 Warrenville Rd Ste 300
Lisle, IL 60532-1348
Phone
(630) 364-7850
Fax
(630) 432-6604
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.028266 IL Primary

Addresses

Primary practice location

430 Warrenville Rd Ste 300
Lisle, IL 60532-1348

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjeffries269168@dulyhealthandcare.direct-ci.com 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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625003912 IL Practitioner - Nurse Practitioner 8022552520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.028266ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jun 17, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 17, 2024 Accepting new patients

Locations

430 Pennsylvania Ave
Glen Ellyn, IL 60137
Phone (630) 545-7576

40 S Clay St
Ste 200
Hinsdale, IL 60521
Phone (630) 364-7850

430 Warrenville Rd
Ste 300
Lisle, IL 60532
Phone (630) 364-7850

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Ste 300
Winfield, IL 60190
Phone (630) 933-8100

Interoperability endpoints

  • Direct secure messaging: jjeffries269168@dulyhealthandcare.direct-ci.com

Organizations & group practices 2

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1649026683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WARRENVILLE RD STE 300",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321348",
            "telephone_number": "630-364-7850",
            "fax_number": "630-432-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "JACLYN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjeffries269168@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "430 Warrenville Rd Ste 300",
            "city": "Lisle",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605321348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.