Active NPI
Jacqueline Ann Richardson, ATC
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1942269261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 5616 W 63Rd St
Chicago, IL 60638-5511 - Phone
- (773) 526-5239
- Fax
- (773) 526-5240
- NPI assigned
- Mar 23, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IL | Primary |
Addresses
Primary practice location
5616 W 63Rd St
Chicago, IL 60638-5511
Mailing address
16908 S Leclaire
Oak Forest, IL 60452
Phone (708) 560-8634
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096001951 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1942269261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16908 S LECLAIRE",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "60452",
"telephone_number": "708-560-8634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5616 W 63RD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606385511",
"telephone_number": "773-526-5239",
"fax_number": "773-526-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Allison Richardson, OTD, OTR/L
- Bonita Richardson, LCSW
- Brenda Dorene Richardson, M.A.,COMS
- Brenda Rose Richardson, COUNSELOR CADC
- Carrie L Richardson, M.D.
- Jessica Richardson, MD
- Julian Leonard Richardson, MD
- Kaitlynn Sen Clair Richardson, MD
- Karen Briggs Richardson, LCSW
- Kathryn Elizabeth Richardson, OTRL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.