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JACKSONEYE SC
NPI 1073669834
Ophthalmology in Lake Villa, IL

Active since January 26, 2007
300 N MILWAUKEE AVE, SUITE L, LAKE VILLA, IL 60046(847) 356-0700(847) 356-0757 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jacksoneye Sc NPPES

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

JACKSONEYE SC (NPI 1073669834) is a healthcare organization registered as an ophthalmology in Lake Villa, Illinois and active in the NPI registry since January 2007. The organization lists Mitchell Alin Jackson, Ceo Owner, as its authorized official.

NPPES Registry Identity

NPI1073669834
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameJACKSONEYE SC
Location Address300 N MILWAUKEE AVE, SUITE LLake Villa, IL 60046
Mailing Address300 N Milwaukee Ave, Suite LLake Villa, IL 60046 · (847) 356-0700 · Fax (847) 356-0700
Phone(847) 356-0700
Fax(847) 356-0757
Organization SubpartNo
Authorized OfficialMitchell Alin JacksonCeo Owner · (847) 356-0700
Enumeration DateJanuary 26, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1073669834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
300 N MILWAUKEE AVE, Lake Villa, IL 60046
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Other Identifiers 1

Other0004932263IL · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacksoneye Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Jacksoneye Sc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Mitchell Jackson, MD
Ophthalmology
NPI 1902958929
300 N MILWAUKEE AVE SUITE L JACKSONEYE SC
Lake Villa, IL 60046
(847) 356-0700
✔ PECOS✔ Accepts MedicareSame address
Vanee Virasch, MD
Ophthalmology
NPI 1740459403
1725 W HARRISON ST #918
Chicago, IL 60612
(312) 942-2734
✔ PECOS✔ Accepts Medicare43 mi

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacksoneye Sc's NPI number?

The NPI number for Jacksoneye Sc is 1073669834. It was assigned to this organization in the NPPES registry on January 26, 2007.

Where is Jacksoneye Sc located?

Jacksoneye Sc is located at 300 N Milwaukee Ave Suite L, Lake Villa, IL 60046. The listed phone number is (847) 356-0700.

What is Jacksoneye Sc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Jacksoneye Sc enrolled in Medicare?

Yes. Jacksoneye Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jacksoneye Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Ophthalmology, reassign their Medicare billing to Jacksoneye Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jacksoneye Sc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.