Jackie Smith

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

217.010815 Issued in IL

Practice address

2N564 Bernice Ave
Glen Ellyn, IL 60137-2823

Phone

(815) 514-4789

NPI assigned

Aug 12, 2026

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

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

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1952226532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2N564 BERNICE AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601372823",
            "telephone_number": "815-514-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2N564 BERNICE AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601372823",
            "telephone_number": "815-514-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217.010815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krisanne Sisto, M.D.
• Skyline Physicians LLC
• Brian A Smart, MD
• SMC Medical Professionals LTD
• Fraser A Smith, LDN
• Jordan Smith, DPT
• Margot Smith, MS, LMFT
• Aladdin Soliman, DMD
• Jessica Lynn Soljacich
• Elisabeth Sparling, RDN

• Speech-Language Assistant in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Speech-Language Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.