MRS. TRACY I JACKSON (NPI# 1871894899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871894899 |
| Entity Type | Individual |
| Full Name | MRS. TRACY I JACKSON |
| Credential | APRN, FNP-BC |
| Practice Address |
2209 Howard St Evanston IL 60202-3636 |
| Mailing Address |
1810 Lake Street Evanston IL 60201 |
| Practice Telephone | 8477331166 |
| Mailing Telephone | 8475630295 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2019-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041315953 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209012646 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639611486 | Tracy Lynn Jackson | Behavior Technician | 412 S Central Ave, Idabel, OK 74745-6060 | 2016-11-10 |
| 1952779209 | Tracy Jackson | Nurse's Aide | 11210 Orville Ave, Cleveland, OH 44106-1327 | 2015-09-03 |
| 1982902516 | Tracy Ann Jackson | Speech-Language Pathologist | 6395 Polo Club Dr, Cumming, GA 30040-5716 | 2011-03-07 |
| 1154436590 | Tracy P Jackson | Anesthesiology | 719 Thompson Ln Ste 22209, Nashville, TN 37204-4692 | 2006-08-19 |
| 1740203496 | Tracy Leslie Jackson | Dentist | 1731 Manatee Ave E, Bradenton, FL 34208 | 2006-07-25 |
| 1568879732 | Tracy Jackson | Counselor | 24077 State Highway 49, Nevada City, CA 95959-8519 | 2014-07-18 |
| 1992003594 | Tracy Elaine Jackson | Pharmacist | 1000 Broad St, Sumter, SC 29150-2505 | 2011-03-05 |
| 1932334091 | Tracy Jackson | Nurse Practitioner | 1389 N Baldwin Ave, Marion, IN 46952-1913 | 2009-05-19 |
| 1295902971 | Tracy Jackson | Registered Nurse | 1487 W Keiser Ave, Osceola, AR 72370-2806 | 2008-05-13 |
| 1154461283 | Tracy Letia Jackson | Physician Assistant | 215 W 125th St, New York, NY 10027-4426 | 2007-02-07 |
| Street Address |
2209 HOWARD ST |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407878218 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 2209 Howard St, Evanston, IL 60202-3636 | 2006-07-24 |
| 1417478553 | Fatima El Hawary | Nurse Practitioner | 2209 Howard St, Evanston, IL 60202-3636 | 2017-06-28 |
| 1063871028 | Anelia Stamatova | Nurse Practitioner | 2209 Howard St, Evanston, IL 60202-3636 | 2016-02-18 |
| 1336508753 | Irene Cheung | Nurse Practitioner | 2209 Howard St, Evanston, IL 60202-3636 | 2016-02-12 |
| 1730579350 | Target | Pharmacy Technician | 2209 Howard St, Evanston, IL 60202-3636 | 2015-02-03 |
| 1881094167 | Nabila Mirza | Pharmacist | 2209 Howard St, Evanston, IL 60202-3636 | 2014-08-24 |
| 1619398641 | John A Kirklys | Pharmacist | 2209 Howard St, C/o Target Pharmacy, Evanston, IL 60202-3636 | 2013-12-17 |
| 1225465487 | Diana Diakakis | Nurse Practitioner | 2209 Howard St, Evanston, IL 60202-3636 | 2013-10-02 |
| 1356636922 | Ellen Edelman | Pharmacist | 2209 Howard St, T0927, Evanston, IL 60202-3636 | 2011-06-12 |
| 1669767448 | Cheryl Lynn Jezwinski | Pharmacist | 2209 Howard St, Evanston, IL 60202-3636 | 2011-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1528574472 | Jessica Kubacki | Developmental Therapist | 535 Hinman Ave Apt F3, Evanston, IL 60202 | 2017-12-14 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| Find all providers in zip 60202 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103291 | Mary Driscoll | Nurse Practitioner | 800 Austin St Ste 207, Evanston, IL 60202-3442 | 2020-08-01 |
| 1013566892 | Reba Elizabeth Mathew | Nurse Practitioner | 500 Asbury Ave # 316-3320, Evanston, IL 60202-2724 | 2019-09-05 |
| 1952768210 | Jacqueline Christie | Nurse Practitioner | 215d Dodge Ave, Evanston, IL 60202-3669 | 2016-01-18 |
| 1962873075 | Laura E Hilb | Nurse Practitioner | 2121 Dewey Ave, Evanston, IL 60201-3057 | 2015-10-14 |
| 1871982876 | Mirela Shuleva | Nurse Practitioner | 2221 Central St Apt 3e, Evanston, IL 60201-5750 | 2015-01-13 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1720303993 | Olatokunbo Olorunfemi | Nurse Practitioner | 3333 Central Street, Evanston, IL 60201-1150 | 2010-03-31 |
| 1598868689 | Mary Elizabeth Coffeen-carley | Nurse Practitioner | 831 St. Highway, 150 South, Wyoming State Hospital, Evanston, WY 82931 | 2006-09-06 |
| 1982614723 | Kimberly S Larson | Nurse Practitioner | 170 Arrowhead Dr, Evanston, WY 82930-9266 | 2006-08-08 |
| 1013916519 | Evanston Clinic Corp | Nurse Practitioner | 196 Arrowhead Dr Ste 8, Evanston, WY 82930-8752 | 2005-07-18 |
| Find all providers in EVANSTON | ||||
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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.