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DR. JACKSON I NEWBERRY III
NPI 1538673116
Counselor in Mundelein, IL

Active since November 19, 2017PECOS EnrolledAccepts Medicare Assignment
201 E PARK ST STE B, MUNDELEIN, IL 60060(847) 262-4393 Get Directions Write a Review

NPPES record last updated: November 19, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jackson I Newberry Iii NPPES

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

DR. JACKSON I NEWBERRY III (NPI 1538673116) is an individual counselor in Mundelein, Illinois and active in the NPI registry since November 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1538673116
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameDR. JACKSON I NEWBERRY III
Location Address201 E PARK ST STE BMundelein, IL 60060-1973
Mailing Address3750 Merrimac Ln WHanover Park, IL 60133-6258 · (630) 267-2885
Phone(847) 262-4393
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 19, 2017
✔ NPI 1538673116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
201 E PARK ST STE B, Mundelein, IL 60060
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jackson I Newberry Iii is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810488962
PECOS Enrollment IDI20251117001479
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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TREVA BUNDY PSYD
Psychologist
201 E PARK ST STE B
MUNDELEIN, IL 60060
Lake County (920) 540-1838
STELLA SMITH LCPC
Counselor (Professional)
201 E PARK ST STE B
MUNDELEIN, IL 60060
Lake County (847) 566-0164
DR. ZHANNAH VAYSMAN PSY.D.
Psychologist (Clinical)
201 E PARK ST STE B
MUNDELEIN, IL 60060
Lake County (847) 566-0164
MRS. ELLEN RUTH BROWN
Counselor (Professional)
201 E PARK ST STE B
MUNDELEIN, IL 60060
Lake County (847) 566-0164

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 Jackson Newberry's NPI number?

The NPI number for Jackson Newberry is 1538673116. It was assigned to this individual provider in the NPPES registry on November 19, 2017.

Where is Jackson Newberry located?

Jackson Newberry practices at 201 E Park St Ste B, Mundelein, IL 60060. The listed phone number is (847) 262-4393.

What is Jackson Newberry's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jackson Newberry enrolled in Medicare?

Yes. Jackson Newberry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jackson Newberry was last updated on November 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.