Individual provider Active NPI

Karen Jackson, M.D.

  • Pulmonary Disease Physician
  • Chicago, IL
National Provider Identifier
1871989483
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036.155734 Issued in IL
Practice address
1725 W Harrison St Ste 010
Chicago, IL 60612-3861
Phone
(312) 942-6744
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036.155734 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 010
Chicago, IL 60612-3861

Mailing address

1725 W Harrison St Ste 010
Chicago, IL 60612-3861

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjackson25799@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190729002956 TN Practitioner - Internal Medicine 7214239813 Reassigns benefits to 1 organization
I20210825003369 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7214239813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Loyola University of Chicago, Stritch School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Suite 10
Chicago, IL 60612-3849
Phone (312) 942-6744

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.155734ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Medical Group, Inc CurrentSince Jul 1, 2019 Accepting new patients
Maury Regional Hospital Marshall Medical Center CurrentSince Jul 1, 2019 Accepting new patients
Rush University Medical Group CurrentSince Aug 1, 2021 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1411 S Michigan Ave
Fl 5
Chicago, IL 60605
Phone (312) 454-2700

1725 W Harrison St
Ste 10
Chicago, IL 60612
Phone (312) 563-3700

1222 Trotwood Ave
Ste 601
Columbia, TN 38401
Phone (931) 381-2062

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

1222 Trotwood Ave
Ste 503
Columbia, TN 38401
Phone (931) 380-9166

Interoperability endpoints

  • Direct secure messaging: kjackson183319@direct.rush.rush-health.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1871989483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123861",
            "telephone_number": "312-942-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KAREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-07-20",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036.155734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjackson25799@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1161 21st Ave S",
            "address_2": "D-3100 Medical Center North",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372322358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.