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MS. JACQUELINE WILCOX RD, LDN
NPI 1316368723
Dietitian, Registered in Decatur, IL

Active since January 02, 2014
1800 E LAKE SHORE DR, DECATUR, IL 62521(217) 464-2966 Get Directions Write a Review

NPPES record last updated: January 2, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ms. Jacqueline Wilcox Rd, Ldn NPPES

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

MS. JACQUELINE WILCOX RD, LDN (NPI 1316368723) is an individual dietitian, registered in Decatur, Illinois, licensed in Illinois (164.006109) and active in the NPI registry since January 2014. She is a graduate of Southern Illinois University School Of Medicine (2013).

NPPES Registry Identity

NPI1316368723
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMS. JACQUELINE WILCOXCredential: RD, LDN
Location Address1800 E LAKE SHORE DRDecatur, IL 62521-3810
Mailing Address1800 E Lake Shore DrDecatur, IL 62521-3810
Phone(217) 464-2966
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 2013
Enumeration DateJanuary 2, 2014
✔ NPI 1316368723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in IL · 164.006109
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1800 E LAKE SHORE DR, Decatur, IL 62521
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Jacqueline Wilcox Rd, Ldn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527556240
PECOS Enrollment IDI20251023001991

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Wilcox reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Patel Medical Group P.C.
167 mi
Multi-Specialty
20330 N DEER PARK BLVD STE 130
Deer Park, IL 60010
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Patel Medical Group PC
  • 2 clinicians in this Medicare group
NPI 1104696012 (312) 625-1889

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

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.

MARY KATHERINE KENNEY PA
Physician Assistant (Medical)
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2966
DR. MICHAEL CHOI MD
Pathology (Anatomic Pathology & Clinical Pathology)
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2017
CHRISTINE M MEEKER N.P.
Nurse Practitioner
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2126
SOMAN NAIR MD
Radiology (Diagnostic Radiology)
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2984
KRISTINA KAY BRADFORD APN
Nurse Practitioner (Family)
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2966
MRS. KRISTEN LEE GROHNE SLP
Speech-Language Pathologist
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2415
MARY CRISLER
Nurse Practitioner (Psychiatric/Mental Health)
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2540
CENTRAL ILLINOIS EMERGENCY PHYSICIANS, LLP
Emergency Medicine
1800 E LAKE SHORE DR
DECATUR, IL 62521
Macon County (217) 464-2966

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 Jacqueline Wilcox's NPI number?

The NPI number for Jacqueline Wilcox is 1316368723. It was assigned to this individual provider in the NPPES registry on January 2, 2014.

Where is Jacqueline Wilcox located?

Jacqueline Wilcox practices at 1800 E Lake Shore Dr, Decatur, IL 62521. The listed phone number is (217) 464-2966.

What is Jacqueline Wilcox's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Jacqueline Wilcox enrolled in Medicare?

Yes. Jacqueline Wilcox is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Wilcox's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Wilcox reassigns Medicare benefits to Patel Medical Group P.C. (Deer Park, IL). 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 Jacqueline Wilcox'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 Jacqueline Wilcox was last updated on January 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.