Jasmine Jackson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209026093 Issued in IL

Practice address

9551 171St St
Tinley Park, IL 60487-6109

Phone

(708) 873-0062

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24576/brand/1/csg/1/fhir/r4

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.

• Chicago Women'S Health Center

  • Voluntary or Charitable Agency
  • Chicago, IL
  • NPI 1134248313
  NPD (past)

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1841915055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9551 171ST ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876109",
            "telephone_number": "708-873-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9551 171ST ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876109",
            "telephone_number": "708-873-0062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 W Sunnyside Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606405684",
            "country_code": "US",
            "telephone_number": "773-935-6126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JASMINE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivek Iyengar, M.D.
• Rineeta Elza Jabin-John, PMHNP-BC, APRN
• Jach Family Wellness Center PLLC
• Thomas Allan Jach, D.C.
• Amy Lauren Jackson, MS
• Katlyn Jackson, RBT
• Mindy Jackson
• Sumar Jackson
• Dinesh K Jain, M.D.
• Bodunrin Jaiyeola, PHARMD

• Family Nurse Practitioner in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.