DR. JOANNA M JACKSON (D.O.) – Emergency Medicine Physician, NPI 1841430139

DR. JOANNA M JACKSON (D.O.) is a healthcare provider. based in Chicago, Illinois. specializing in EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. 02003343A (IN). The NPI Number for DR. JOANNA M JACKSON (D.O.) is 1841430139

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOANNA M JACKSON (D.O.)
NPI
1841430139
Phone
(847) 707-6926
Address
1070 N HERMITAGE AVE
Enumeration Date
25 February 2009
Last Update Date
11 February 2022

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
5713008000
Graduation Year
2006 (20 years ago)
PAC ID
1557495652
Group Practice PAC ID
0648717512
Professional Enrollment ID
I20251117003108
Address ID
VA221912171WO14087HWYX301

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

2,845 EMERGENCY MEDICINE in IL

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Provider Addresses for DR. JOANNA M JACKSON (D.O.)

  • 1070, North Hermitage Avenue, Pulaski Park, Wicker Park, West Town, Chicago, West Chicago Township, Cook County, Illinois, 60622, United States

    APT 1F

    CHICAGO, IL 606223272

    Phone: (847) 707-6926

    Type: Mailing

  • Crawford Avenue, Olympia Fields, Rich Township, Cook County, Illinois, 60443, United States of America

    C/O POSTDOCTORAL EDUCATION

    OLYMPIA FIELDS, IL 604611010

    Phone: (708) 747-4000

    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: 2025-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251112000177IEmergency MedicineDCTBD
I20251117003108IEmergency MedicineVATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60622)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648717512View full group profile
NameSpecialtyState
Emergency Medicine, Family Practice, Family PracticeVA
Physician AssistantDC
Nurse PractitionerGA
Nurse PractitionerVA
Nurse PractitionerDC
Nurse PractitionerMD
Physician AssistantVA
Pediatric Medicine, General PracticeVA
Physician AssistantMD

Reviews

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Frequently asked questions

Can I cross-check DR. JOANNA M JACKSON (D.O.) using NPI 1841430139?
NPI 1841430139 belongs to DR. JOANNA M JACKSON (D.O.); compare other details if you need extra assurance.
Is DR. JOANNA M JACKSON (D.O.) shown as active in public data?
Registry records indicate DR. JOANNA M JACKSON (D.O.) maintains an active NPI.
What clinical focus is listed for DR. JOANNA M JACKSON (D.O.)?
At a glance, DR. JOANNA M JACKSON (D.O.) is tied to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. JOANNA M JACKSON (D.O.)?
Directory geography for DR. JOANNA M JACKSON (D.O.) centers on Chicago, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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