DR. EVAN LEIGH JACKSON DO
NPI 1013412634
Emergency Medicine in Chicago, IL

Q: What is Evan Jackson's NPI number?

The NPI number for Evan Jackson is 1013412634. It was assigned to this individual provider in the NPPES registry on March 26, 2018.

Q: What is Evan Jackson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Evan Jackson was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 26, 2018PECOS EnrolledAccepts Medicare Assignment

1740 W TAYLOR ST, CHICAGO, IL 60612(866) 600-2273 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 21, 2022, Oct 18, 2021, Jul 7, 2021 and 3 more (6 updates tracked since 2018).

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About Dr. Evan Leigh Jackson Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EVAN LEIGH JACKSON DO (NPI 1013412634) is an individual emergency medicine provider in Chicago, Illinois, licensed in Illinois (036155621) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with Mt Sinai Hospital Medical Center, and is a graduate of Touro Un College Of Osteopathic Medicine, Vallejo (2018).

NPPES Registry Identity

NPI1013412634

Entity TypeIndividualFemale

Primary Taxonomy207P00000X

Provider Legal NameDR. EVAN LEIGH JACKSONCredential: DO

Location Address1740 W TAYLOR STChicago, IL 60612-7232

Mailing Address808 South Wood Street, 469 Cme, M/c 724Chicago, IL 60612 · (312) 413-7492

Phone(866) 600-2273

Sole ProprietorYes

Medical School CMSTouro Un College Of Osteopathic Medicine, VallejoGraduated 2018

Enumeration DateMarch 26, 2018

Last NPPES UpdateApril 30, 20256 updates tracked since enumeration

NPPES CertifiedApril 30, 2025

✔ NPI 1013412634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in IL · 036155621✔ Licensed in IN · 02006363A✔ Licensed in IL · 125.073354

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

1740 W TAYLOR ST, Chicago, IL 60612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Evan Leigh Jackson Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416205430

PECOS Enrollment IDI20211025000142

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Evan Jackson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Board Of Trustees Of The University Of Illinois

Same address

Anesthesiology

1740 W TAYLOR ST
Chicago, IL 60612

Reassigned Medicare billing, Illinois enrollment
2,127 clinicians in this Medicare group

NPI 1013136282 (312) 996-4020

Cepamerica Illinois LLP

1.4 mi

Emergency Medicine

1500 S FAIRFIELD AVE
Chicago, IL 60608

Reassigned Medicare billing, Illinois enrollment
982 clinicians in this Medicare group

NPI 1265954465 (773) 542-2000

Osf Multi-Specialty Group

128 mi

Internal Medicine

8600 N STATE ROUTE 91
Peoria, IL 61615

Reassigned Medicare billing, Illinois enrollment
2,944 clinicians in this Medicare group

NPI 1154908929 (309) 683-5050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

129 services125 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

113 services113 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

32 services32 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

17 services17 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mt Sinai Hospital Medical Center

Acute Care Hospitals · Chicago, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140018

Location1500 S Fairfield AveChicago, IL 60608 · Cook County

Emergency services Birthing friendly

Holy Cross Hospital

Acute Care Hospitals · Chicago, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140133

Location2701 W 68th StreetChicago, IL 60629 · Cook County

Emergency services

University Of Illinois Hospital And Clinics

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number140150

Location1740 West Taylor St Suite 1400Chicago, IL 60612 · Cook County

Emergency services Birthing friendly

Osf Little Company Of Mary Medical Center

Acute Care Hospitals · Evergreen Park, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140179

Location2800 W 95th StEvergreen Park, IL 60805 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CATHLEEN CONWAY JENSEN OTR/L

Occupational Therapist

1740 W TAYLOR ST, C100
CHICAGO, IL 60612

Cook County (312) 996-3700

KELLY M HOYERT PA-C

Physician Assistant (Surgical)

1740 W TAYLOR ST, 3F OCC
CHICAGO, IL 60612

Cook County (312) 355-4300

DR. YI-LOONG COLIN WOON M.D.

Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)