JACKSON CORP (NPI# 1588816623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588816623 |
| Entity Type | Organization |
| Organization Name | JACKSON CORP |
| Other Organization Name | JACKSON SQUARE NURSING & REHAB CENTER |
| Practice Address |
5130 W Jackson Blvd Chicago IL 60644-4332 |
| Mailing Address |
7257 N Lincoln Ave Lincolnwood IL 60712-1810 |
| Practice Telephone | 7739218000 |
| Practice Fax Number | 7739213980 |
| Mailing Telephone | 8479332600 |
| Mailing Fax Number | 8479330686 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |
| Authorized Official Name | JOYCE RUDD (MEDICARE MANAGER) |
| Authorized Official Telephone | 8477456238 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 5074210001 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| JACKSON SQUARE NURSING & REHAB CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740351972 | Jackson Corp | Durable Medical Equipment & Medical Supplies | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2006-11-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Jackson Corp. | 1372 W Hoye Pl, Denver, CO 80223 |
| Street Address |
5130 W JACKSON BLVD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60644-4332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740351972 | Jackson Corp | Durable Medical Equipment & Medical Supplies | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2006-11-10 |
| 1437708963 | Jessica Lake | Speech-Language Pathologist | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2019-09-07 |
| 1376025304 | Loretto Hospital | Clinic/Center | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2018-09-06 |
| 1578941340 | Symphony Jackson Square LLC | Skilled Nursing Facility | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2015-05-13 |
| 1881006989 | Jennifer Burns | Occupational Therapist | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2014-05-22 |
| 1235554486 | Bryan De Rosas | Occupational Therapist | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2014-02-25 |
| 1740540848 | Emily R Gomeztagle | Speech-Language Pathologist | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2012-05-22 |
| 1356578900 | Jackson Square Skilled Nursing Aand Living | Durable Medical Equipment & Medical Supplies | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2009-06-22 |
| 1255592234 | Green Healthcare Ltd. | Nurse Practitioner | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2008-06-22 |
| 1831364132 | Loretto Hospital | Clinic/Center | 5130 W Jackson Blvd, Chicago, IL 60644-4332 | 2008-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535638 | Marta Yvonne Palmer | Technician | 5008 W Adams, Chicago, IL 60644 | 2019-09-04 |
| 1861056848 | B U I L D Incorporated | Social Worker | 5100 W Harrison St., Chicago, IL 60644 | 2019-04-25 |
| 1851806269 | Habilitative Systems, Inc. | Case Management | 4732 W Ohio St, Chicago, IL 60644 | 2017-12-07 |
| 1336408665 | Meghan Nancy Daw | Dietitian, Registered | 646 S Central Ave, Chicago, IL 60644 | 2012-05-07 |
| 1164790515 | Elizabeth Eleanor Reid-tate | Pharmacist | 5222 W. Madison Avenue, Chicago, IL 60644 | 2011-12-13 |
| 1134458466 | Power Teen Program | Psychologist | 300 N Central Ave, Chicago, IL 60644 | 2009-12-16 |
| 1417198342 | Betty Jean Lofton | Counselor | 5938 W. Midway Park, Chicago, IL 60644 | 2009-03-24 |
| 1881856094 | Sanjay M. Patel M.d. S.c. | Psychiatry & Neurology | 5730 W. Roosevelt Road, Chicago, IL 60644 | 2008-06-29 |
| 1639348691 | Ysl Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 5107-21 West Jackson Blvd, Chicago, IL 60644 | 2008-02-25 |
| 1073795845 | Maryanne Rakidzioski | Occupational Therapist | 5103 W Jackson Blvd, Chicago, IL 60644 | 2007-12-03 |
| Find all providers in zip 60644 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053812974 | Alden Estates-courts of Huntley, Inc. | Skilled Nursing Facility | 4200 W Peterson Ave Ste 140, Chicago, IL 60646-6819 | 2018-02-26 |
| 1194271825 | Veronica Mack | Skilled Nursing Facility | 9738 S Merrion Ave, Chicago, IL 60617-4846 | 2016-09-01 |
| 1982050886 | Bernadette Aguilar | Skilled Nursing Facility | 125 S Green St, Unit 808a, Chicago, IL 60607-3197 | 2016-05-10 |
| 1720445539 | Maria Callahan | Skilled Nursing Facility | 1839 S Prairie Pkwy, Chicago, IL 60616-4389 | 2016-01-25 |
| 1265856710 | Royal Staff Inc | Skilled Nursing Facility | 10934 S Beverly Ave, Chicago, IL 60643-3752 | 2014-02-04 |
| 1114355336 | Mobile Anesthesiologist | Skilled Nursing Facility | 8420 Bryn Mawr, Chicago, IL 60631 | 2013-10-25 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1982946604 | Admiral At The Lake | Skilled Nursing Facility | 933 W. Foster Ave, Chicago, IL 60640 | 2013-03-20 |
| 1730447566 | Sound Imaging Inc. | Skilled Nursing Facility | 6970 N Mcalpin Ave, Chicago, IL 60646-1141 | 2012-04-30 |
| 1821355561 | Ltc Practitioners of Illinois | Skilled Nursing Facility | 3915 N. Kenneth Ave., Chicago, IL 60641-2816 | 2012-04-19 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.