JACLYN LEIBFORTH
NPI 1356117253
Nurse Practitioner - Acute Care in Chicago, IL

Q: What is Jaclyn Leibforth's NPI number?

The NPI number for Jaclyn Leibforth is 1356117253. It was assigned to this individual provider in the NPPES registry on November 30, 2023.

Q: What is Jaclyn Leibforth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Leibforth was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since November 30, 2023PECOS Enrolled

5841 S MARYLAND AVE, CHICAGO, IL 60637(888) 824-0200 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jaclyn Leibforth NPPES

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

JACLYN LEIBFORTH (NPI 1356117253) is an individual acute care provider in Chicago, Illinois, licensed in Illinois (209.028063) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, is affiliated with Loyola Gottlieb Memorial Hospital, and maintains a secondary practice location in Maywood.

NPPES Registry Identity

NPI1356117253

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameJACLYN LEIBFORTH

Location Address5841 S MARYLAND AVEChicago, IL 60637-1443

Mailing Address1242 W Huron St Apt 1Chicago, IL 60642-0036

Phone(888) 824-0200

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateNovember 30, 2023

Last NPPES UpdateJune 8, 2026

NPPES CertifiedJune 8, 2026

✔ NPI 1356117253 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in IL · 209.028063

5841 S MARYLAND AVE, Chicago, IL 60637

Open in Google Maps ↗

Secondary Practice Location 1

Location 12160 S 1st AveMaywood, IL 60153-3328 · Phone (888) 584-7888

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Leibforth is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1850734211

PECOS Enrollment IDI20240213002201

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

57 services38 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Loyola Gottlieb Memorial Hospital

Acute Care Hospitals · Melrose Park, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140008

Location701 West North AveMelrose Park, IL 60160 · Cook County

Emergency services

Loyola University Medical Center

Acute Care Hospitals · Maywood, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140276

Location2160 S 1st AvenueMaywood, IL 60153 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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.

DR. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)