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JODY HANNAH LACK MD
NPI 1235351818
Pediatrics in Springfield, IL

Active since May 03, 2007PECOS Enrolled
415 N 9TH ST, STE 4W64, SPRINGFIELD, IL 62702(217) 545-0003(217) 545-7615 Get Directions Write a Review

NPPES record last updated: January 13, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jody Hannah Lack Md NPPES

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

JODY HANNAH LACK MD (NPI 1235351818) is an individual pediatrics provider in Springfield, Illinois, licensed in Illinois (036-122811) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235351818
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJODY HANNAH LACKCredential: MD
Location Address415 N 9TH ST, STE 4W64Springfield, IL 62702-5303
Mailing AddressPo Box 19676Springfield, IL 62794-9676 · (217) 545-0003 · Fax (217) 545-7615
Phone(217) 545-0003
Fax(217) 545-7615
Sole ProprietorNo
Enumeration DateMay 3, 2007
Last NPPES UpdateJanuary 13, 2011
✔ NPI 1235351818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 036-122811
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
415 N 9TH ST, Springfield, IL 62702
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Other Identifiers 2

Medicaid036122811IL
Medicare PIN256510084IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jody Hannah Lack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

ROBERT MARC ABRAMS M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
415 N 9TH ST, 6W100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-5117
DR. SARA BETH RUBENACKER M.D.
Obstetrics & Gynecology
415 N 9TH ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-5117
JUSTINE HOLLE MORGAN CFNP
Clinical Nurse Specialist (Oncology, Pediatrics)
415 N 9TH ST, SUITE 2W106
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7377
DR. KIMBERLY NICHOLE POWELL MD
Pediatrics (Pediatric Critical Care Medicine)
415 N 9TH ST, SUITE 4W16
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
DR. ELIZABETH RAMSEY UNAL MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
415 N 9TH ST, STE 6W100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-5117
LORIE SPORRER FNP-BC
Nurse Practitioner (Family)
415 N 9TH ST, SUITE 6W100
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
DR. HAYLEE ELIZABETH ELVENDAHL-RUMLEY DO
Obstetrics & Gynecology
415 N 9TH ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
DR. KRISTEN LEADBETTER M.D.
Pediatrics (Neonatal-Perinatal Medicine)
415 N 9TH ST, STE 4W16
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000

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 Jody Lack's NPI number?

The NPI number for Jody Lack is 1235351818. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Where is Jody Lack located?

Jody Lack practices at 415 N 9th St Ste 4w64, Springfield, IL 62702. The listed phone number is (217) 545-0003.

What is Jody Lack's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jody Lack enrolled in Medicare?

Yes. Jody Lack is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jody Lack was last updated on January 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.