DR. JENNIFER MARIE BELLUCCI JACKSON (NPI# 1689669293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689669293 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER MARIE BELLUCCI JACKSON |
| Credential | MD |
| Practice Address |
431 W Liberty St Wauconda IL 60084-2452 |
| Mailing Address |
Po Box 6037 431 W Liberty St Wauconda IL 60084-6037 |
| Practice Telephone | 8475262151 |
| Practice Fax Number | 8475262017 |
| Mailing Telephone | 8475262151 |
| Mailing Fax Number | 8475262017 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036083207 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036083207 | 05 |
| Street Address |
431 W LIBERTY ST |
| City | WAUCONDA |
| State | IL |
| Zip Code | 60084-2452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356335996 | David J Alengo | Family Medicine | 431 W Liberty St, Wauconda, IL 60084-2452 | 2005-09-09 |
| 1104423094 | Corrie Mcmahon | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2020-10-05 |
| 1093349391 | Celestia Arendall Nielsen | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2020-02-25 |
| 1881242725 | Nicole Hendrickson | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2019-09-03 |
| 1619529138 | Wendy Marie Belletynee | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2019-07-15 |
| 1508336918 | Lisabeth N. Morrisroe | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-11-28 |
| 1053800516 | Karen Anne Fermin Violago | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-05-09 |
| 1114415205 | Kaitlyn Jamie Lundgren | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084 | 2018-04-25 |
| 1396246450 | Jessica Helen Partyka | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084-2452 | 2018-02-23 |
| 1841718087 | Michelle Naurecki | Nurse Practitioner | 431 W Liberty St, Wauconda, IL 60084 | 2017-09-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891305660 | Reynaldo D Dado | Physical Medicine & Rehabilitation | 2751 Cedar Creek Cut-off Rd, Wauconda, IL 60084 | 2020-08-05 |
| 1841719705 | Aneena Susan Philip | Pharmacist | 547 W Liberty Street, Wauconda, IL 60084 | 2017-09-12 |
| 1164897476 | Laura Dobson | Nurse Practitioner | 450 West Route 22, Wauconda, IL 60084 | 2015-12-11 |
| 1366816514 | Family Medicine Specialists, S.c. | Non-Pharmacy Dispensing Site | 431 W Liberty Street, Wauconda, IL 60084 | 2015-11-25 |
| 1922408822 | Accuvision Inc | Optometrist | 573 W. Liberty, Wauconda, IL 60084 | 2014-08-27 |
| 1982041851 | Sara J Hollis | Counselor | 227 N. Main Street, Wauconda, IL 60084 | 2013-05-31 |
| 1639321482 | Stacie Wharton | Physician Assistant | 431 West Liberty Street, Wauconda, IL 60084 | 2008-10-10 |
| 1336207893 | Kurt Allan Bohl | Dentist | 469 West Liberty Street, Suite C, Wauconda, IL 60084 | 2006-12-05 |
| 1316013386 | William Richard Womer | Chiropractor | 604 E Liberty St, Wauconda, IL 60084 | 2006-11-28 |
| 1639283583 | Luis Planas | Internal Medicine | 363 N Main St, Wauconda, IL 60084 | 2006-08-18 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803560 | Rebecca Joy Westrate | Family Medicine | 224 Brown St Ste A, Wauconda, IL 60084-1747 | 2020-02-19 |
| 1356335996 | David J Alengo | Family Medicine | 431 W Liberty St, Wauconda, IL 60084-2452 | 2005-09-09 |
| 1023002383 | Warren G Kruckmeyer | Family Medicine | 224 Brown St, Wauconda, IL 60084-1747 | 2005-09-01 |
| 1922170265 | Kathleen Marie Mariani | Family Medicine | 431 W Liberty St, Wauconda, IL 60084-2452 | 2006-11-14 |
| 1063406601 | Family Medicine Specialists, S.c. | Family Medicine | 431 W Liberty St, Wauconda, IL 60084-2452 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
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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.