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CYNTHIA ANN JACK NP
NPI 1710222807
Nurse Practitioner in Rockford, IL

Active since November 30, 2012
2300 N ROCKTON AVE, ROCKFORD, IL 61103(815) 971-2000 Get Directions Write a Review

NPPES record last updated: September 18, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cynthia Ann Jack Np NPPES

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

CYNTHIA ANN JACK NP (NPI 1710222807) is an individual nurse practitioner in Rockford, Illinois, licensed in Illinois (209.009900) and active in the NPI registry since November 2012. She maintains a secondary practice location in Woodstock.

NPPES Registry Identity

NPI1710222807
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCYNTHIA ANN JACKCredential: NP
Location Address2300 N ROCKTON AVERockford, IL 61103-3619
Mailing Address2300 N Rockton AveRockford, IL 61103-3619 · (815) 971-2000
Phone(815) 971-2000
Sole ProprietorNo
Enumeration DateNovember 30, 2012
Last NPPES UpdateSeptember 18, 2020
NPPES CertifiedSeptember 18, 2020
✔ NPI 1710222807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209.009900
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Occupational HealthTaxonomy 363LX0106X · License 209009900 (IL)
2300 N ROCKTON AVE, Rockford, IL 61103
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Secondary Practice Location 1

Location 12000 Lake AveWoodstock, IL 60098-7401 · Phone (815) 337-7100

Other Identifiers 2

Medicaid1710222807WI
Other209.009900IL · State Of Illinois License

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.

JENNIFER DAVIDSON OT
Occupational Therapist
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2000
ROBIN R. HOVIS MD
Internal Medicine (Rheumatology)
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2000
DR. JOSEPH R WHITELEY M.D.
Surgery (Plastic and Reconstructive Surgery)
2300 N ROCKTON AVE, STE 304
ROCKFORD, IL 61103
Winnebago County (815) 964-3333
ROCKFORD HEALTH PHYSICIANS
Clinic/Center (Multi-Specialty)
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2000
MICHELLE KLUNK PTA
Physical Therapy Assistant
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2000
DR. SARAH M. BEAVES MD
Pediatrics
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2000
ERIKA J OLTMANNS RD, LDN
Dietitian, Registered
2300 N ROCKTON AVE
ROCKFORD, IL 61103
Winnebago County (815) 971-2511
MRS. JESSICA A BARR APRN,BC
Nurse Practitioner (Family)
2300 N ROCKTON AVE, ROCKFORD HEALTH PHYSICIANS
ROCKFORD, IL 61103
Winnebago County (815) 971-2000

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 Cynthia Jack's NPI number?

The NPI number for Cynthia Jack is 1710222807. It was assigned to this individual provider in the NPPES registry on November 30, 2012.

Where is Cynthia Jack located?

Cynthia Jack practices at 2300 N Rockton Ave, Rockford, IL 61103. The listed phone number is (815) 971-2000.

What is Cynthia Jack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Cynthia Jack was last updated on September 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.