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DR. MARK D JACKSON MD
NPI 1952331019
Internal Medicine - Cardiovascular Disease in Peoria, IL

Active since July 04, 2006
5405 N KNOXVILLE AVE, PEORIA, IL 61614(309) 691-4410(309) 589-2830 Get Directions Write a Review

NPPES record last updated: August 31, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mark D Jackson Md NPPES

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

DR. MARK D JACKSON MD (NPI 1952331019) is an individual cardiovascular disease provider in Peoria, Illinois, licensed in Illinois (036082717) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1952331019
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. MARK D JACKSONCredential: MD
Location Address5405 N KNOXVILLE AVEPeoria, IL 61614
Mailing Address5405 N Knoxville AvePeoria, IL 61614 · (309) 691-4410 · Fax (309) 589-2830
Phone(309) 691-4410
Fax(309) 589-2830
Sole ProprietorNo
Enumeration DateJuly 4, 2006
Last NPPES UpdateAugust 31, 2010
✔ NPI 1952331019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in IL · 036082717
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
5405 N KNOXVILLE AVE, Peoria, IL 61614
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Other Identifiers 3

Medicare UPINE08074IL
Medicare ID-Type UnspecifiedL28116IL
Medicaid036082717IL

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.

CHRISTINE C PERKS MD
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
RICHARD S SEABOCH PA
Physician Assistant
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
VIJAYASREE PALERU M.D.
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
DEAN SCHMIDT ACNP
Nurse Practitioner (Acute Care)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
GERRI HELLHAKE-HALL FNP
Nurse Practitioner (Family)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
DR. NEIL KENT WISE MD
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
MICHAEL GRZESKOWIAK
Internal Medicine (Cardiovascular Disease)
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 691-4410
MRS. WHITNEY RENEE ANDAL APN
Family Medicine
5405 N KNOXVILLE AVE
PEORIA, IL 61614
Peoria County (309) 624-9960

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 Mark Jackson's NPI number?

The NPI number for Mark Jackson is 1952331019. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Mark Jackson located?

Mark Jackson practices at 5405 N Knoxville Ave, Peoria, IL 61614. The listed phone number is (309) 691-4410.

What is Mark Jackson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Mark Jackson was last updated on August 31, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.