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MARCUS JACK
NPI 1306591342
Counselor - Professional in Chicago, IL

Active since February 17, 2022PECOS Enrolled
12400 S MICHIGAN AVE, CHICAGO, IL 60628(770) 912-5225 Get Directions Write a Review

NPPES record last updated: February 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1306591342
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMARCUS JACK
Location Address12400 S MICHIGAN AVEChicago, IL 60628-7347
Mailing Address5640 Stone CtStone Mountain, GA 30087-2954 · (770) 912-5225
Phone(770) 912-5225
Sole ProprietorYes
Enumeration DateFebruary 17, 2022
NPPES CertifiedFebruary 17, 2022
✔ NPI 1306591342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180014299
12400 S MICHIGAN AVE, Chicago, IL 60628
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marcus Jack 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.

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.

What insurance does Marcus Jack accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Marcus Jack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.