Active NPI
Shaniqua Jackson, FNP
- Family Nurse Practitioner
- Oak Lawn, IL
National Provider Identifier
1801562517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.023822
- Practice address
- 4440 W 95TH St
Oak Lawn, IL 60453-2600 - Phone
- (708) 684-8000
- NPI assigned
- Aug 22, 2021
- Last updated
- Sep 4, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.023822 | IL | Primary |
Addresses
Primary practice location
4440 W 95TH St
Oak Lawn, IL 60453-2600
Mailing address
4440 W 95TH St
Oak Lawn, IL 60453-2600
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, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1203 W Augusta Blvd
Chicago, IL 60642-4327
Phone (773) 248-2255
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.25 of 100
- Quality
- 80.59
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.023822 | IL | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
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- Chicago, IL
- NPI 1952937104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630713600000",
"number": "1801562517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600",
"telephone_number": "708-684-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "SHANIQUA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-22",
"last_updated": "2021-09-04",
"certification_date": "2021-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.023822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.