| Jennifer M Bellucci Jackson, MD | |
|
431 W Liberty St, Wauconda, IL 60084-2452 | |
| (847) 526-2151 | |
| (847) 526-2017 |
| Full Name | Jennifer M Bellucci Jackson |
|---|---|
| Gender | Female |
| Speciality | Family Practice |
| Experience | 37 Years |
| Location | 431 W Liberty St, Wauconda, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689669293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036083207 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Advocate Home Health Care Serv | Lombard, IL | Home health agency |
| Northwestern Medicine Mchenry Hospital | Mchenry, IL | Hospital |
| Vista Medical Center East | Waukegan, IL | Hospital |
| Advocate Condell Medical Center | Libertyville, IL | Hospital |
| Northwestern Lake Forest Hospital | Lake forest, IL | Hospital |
| Northshore University Healthsystem - Evanston Hospital | Evanston, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Family Medicine Specialists S.c. | 0042206252 | 23 |
| Family Medicine Specialists Of Round Lake Incorporated S C | 6002957511 | 14 |
| Family Medicine Specialists Of Mount Prospect S C | 8224166566 | 9 |
| Entity Name | Family Medicine Specialists S.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063406601 PECOS PAC ID: 0042206252 Enrollment ID: O20040422001425 |
| Entity Name | Family Medicine Specialists Of Round Lake Incorporated S C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740515253 PECOS PAC ID: 6002957511 Enrollment ID: O20100106000383 |
| Entity Name | Family Medicine Specialists Of Mount Prospect S C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437389475 PECOS PAC ID: 8224166566 Enrollment ID: O20100507000184 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer M Bellucci Jackson, MD Po Box 6037, 431 W Liberty St, Wauconda, IL 60084-6037 Ph: (847) 526-2151 | Jennifer M Bellucci Jackson, MD 431 W Liberty St, Wauconda, IL 60084-2452 Ph: (847) 526-2151 |
Warren G Kruckmeyer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 224 Brown St, Wauconda, IL 60084 Phone: 847-795-3350 Fax: 847-487-2841 | |
David J Alengo, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Anthony Cipolla, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 224 Brown St Ste A, Wauconda, IL 60084 Phone: 847-795-3350 Fax: 847-487-2841 | |
Kathleen Marie Mariani, P.A. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 |