Summer Jackson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209025419 Issued in IL

Practice address

531 Linden Ave
Bellwood, IL 60104-1854

Phone

(773) 416-9936

NPI assigned

Mar 3, 2022

Last updated

Mar 15, 2025By 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 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.11 of 100Reported as group

Quality

92.94

Promoting interoperability

100

Improvement activities

40

Cost

67.44

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Simply Wounds and Lymphatics, PLLC

  • Nurse Practitioner
  • Evergreen Park, IL
  • NPI 1073464301
  Medicare reassignment NPD Authorized official
• West Coast Wound and Skin Care Inc

  • Surgery Physician
  • Burbank, CA
  • NPI 1437675980

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1790432458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 LINDEN AVE",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041854",
            "telephone_number": "773-416-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 LINDEN AVE",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041854",
            "telephone_number": "773-416-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUMMER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "2000357580",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000357580",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmin Hugle
• Human Corps, Inc.
• Jamilia Humphrey, LSW, MSW
• Idoc Inc. (Chicago Eye Center)
• Malonda Jackson
• Frederick Jefferson, LPC, CADC
• Brandon C John, PA-C
• Carrie Johnson, RN
• Mimi V. Johnson, D.D.S.
• Kajas Special Touch, LLC

• Nurse Practitioner in Bellwood, IL
• Providers in Bellwood, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.

Verify at the official NPI Registry.