LORI R JACKSON (MD) – Family Medicine Physician, NPI 1154533271
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
Provider Addresses for LORI R JACKSON (MD)
2650 RIDGE AVE # 1223
EVANSTON, IL 602011700
Phone: (847) 982-3175
Fax: (847) 982-3394
Type: Mailing
915 S WAUKEGAN RD
LAKE FOREST, IL 600452654
Phone: (847) 234-8866
Fax: (847) 234-4682
Type: Location
Carle Foundation Hospital, 611, West Park Street, Urbana, Champaign County, Illinois, 61801, United States
BWPC
URBANA, IL 618012500
Phone: (217) 383-6941
Type: Mailing
Curtis Road, Ogden, Champaign County, Illinois, 61859, United States
CHAMPAIGN, IL 618229678
Phone: (217) 365-6201
Fax: (217) 326-4003
Type: Location
1701 Curtis Rd
Champaign, IL 618229678
Phone: (217) 365-6201
Fax: (217) 326-4003
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2009-01-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090112000350 | I | Family Practice | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 140 | 86 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 38 | 31 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 37 | 37 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 28 | 26 | $0 |
Insurance plans in this area (ZIP 60201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | IL | |
| Nurse Practitioner | IL | |
| Clinical Psychologist | IL | |
| - | FL | |
| Nurse Practitioner | IL | |
| Gastroenterology, Internal Medicine | WI | |
| P O D I A T R Y | IL | |
| Hospitalist, Family Practice | TX | |
| Diagnostic Radiology | NY | |
| - | IL |
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