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MR. KURT H JACKSON
NPI 1104178649
Counselor - Professional in Chicago, IL

Active since October 08, 2012PECOS EnrolledAccepts Medicare Assignment
8044 S RACINE AVE, CHICAGO, IL 60620(773) 723-9291(773) 723-9291 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kurt H Jackson NPPES

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

MR. KURT H JACKSON (NPI 1104178649) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180015933) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1104178649
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. KURT H JACKSON
Location Address8044 S RACINE AVEChicago, IL 60620-3011
Mailing Address2922 Chayes Park DrHomewood, IL 60430-2907 · (708) 289-0203 · Fax (773) 723-9291
Phone(773) 723-9291
Fax(773) 723-9291
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateOctober 8, 2012
Last NPPES UpdateOctober 9, 2024
NPPES CertifiedOctober 9, 2024
✔ NPI 1104178649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in IL · 180015933✔ Licensed in IL · 178006138
8044 S RACINE AVE, Chicago, IL 60620
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Kurt H Jackson 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 ID3779925003
PECOS Enrollment IDI20240531001218
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.

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 Kurt Jackson's NPI number?

The NPI number for Kurt Jackson is 1104178649. It was assigned to this individual provider in the NPPES registry on October 8, 2012.

Where is Kurt Jackson located?

Kurt Jackson practices at 8044 S Racine Ave, Chicago, IL 60620. The listed phone number is (773) 723-9291.

What is Kurt Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kurt Jackson enrolled in Medicare?

Yes. Kurt Jackson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kurt Jackson was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.