Active NPI
Kesha Douglas-Jackson, APN
- Family Nurse Practitioner
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209016670
- Practice address
- 2160 S 1St Ave
Maywood, IL 60153-3328 - Phone
- (872) 231-3162
- Fax
- (708) 795-0101
- NPI assigned
- Oct 1, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209016670 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Maywood, IL 60153-3328
Mailing address
PO Box 74008272
Chicago, IL 60674-8272
Phone (702) 899-0595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041410556 | Other | IL | REGISTERED NURSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1415 W Foster Ave
Chicago, IL 60640-2288
Phone (773) 769-5500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.28 of 100
- Quality
- 73.83
- Improvement activities
- 40
- Cost
- 45.57
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Rehab Consultants LLC | Current | Accepting new patients | |
| Integrated Rehab Consultants LLC | Current | Accepting new patients |
Locations
111 E Washington St
Bensenville, IL 60106
Phone (630) 521-8012
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599
1415 W Foster Ave
Chicago, IL 60640
Phone (630) 307-9617
4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102
2450 N Central Ave
Chicago, IL 60639
Phone (773) 889-1333
1725 S Wabash Ave
Chicago, IL 60616
Phone (312) 842-4400
2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153
401 N Michigan Ave
Ste 1200
Chicago, IL 60611
Phone (224) 496-6940
1040 Robey Ave
Downers Grove, IL 60516
Phone (630) 969-9188
1760 Capital St
Elgin, IL 60124
Phone (847) 531-6004
420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300
2000 W Lake St
Hanover Park, IL 60133
Phone (224) 456-6662
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779
3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200
2406 Hartland Rd
Woodstock, IL 60098
Phone (815) 338-0312
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.
-
- Physical Medicine & Rehabilitation Physician
- Chicago, IL
- NPI 1528379195
-
- Physical Medicine & Rehabilitation Physician
- Baltimore, MD
- NPI 1316829146
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759881600000",
"number": "1720598071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 74008272",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606748272",
"telephone_number": "702-899-0595",
"fax_number": "702-977-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "872-231-3162",
"fax_number": "708-795-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS-JACKSON",
"first_name": "KESHA",
"credential": "APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-01",
"last_updated": "2025-10-08",
"certification_date": "2025-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209016670",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "041410556",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.