MARCUS JACK
NPI 1306591342
Counselor - Professional in Chicago, IL
About Marcus Jack NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARCUS JACK (NPI 1306591342) is an individual professional provider in Chicago, Illinois, licensed in Illinois (180014299) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Marcus Jack is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Marcus Jack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, Illinois enrollment
- 581 clinicians in this Medicare group
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 Marcus Jack's NPI number?
The NPI number for Marcus Jack is 1306591342. It was assigned to this individual provider in the NPPES registry on February 17, 2022.
Where is Marcus Jack located?
Marcus Jack practices at 12400 S Michigan Ave, Chicago, IL 60628. The listed phone number is (770) 912-5225.
What is Marcus Jack's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Marcus Jack enrolled in Medicare?
Yes. Marcus Jack is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Marcus Jack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marcus Jack reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The 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 Marcus Jack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Marcus Jack was last updated on February 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Marcus Jack · NPI 1306591342
Professional provider in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since February 17, 2022.
## Identity
- **NPI:** 1306591342 (Entity type: Individual)
- **Enumerated:** February 17, 2022
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 180014299 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 12400 S MICHIGAN AVE, Chicago, IL 60628-7347
- **Phone:** (770) 912-5225
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 17, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1306591342) · Data from the CMS NPPES public registry.