Ms Jacqueline Marie Nichols, - Medicare Nurse Practitioner in Lombard, IL

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Ms Jacqueline Marie Nichols, is a medicare enrolled "Nurse Practitioner - Family" in Lombard, Illinois. She graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Endeavor Health Medical Group, Elmhurst Memorial Hospital and her current practice location is 130 S Main St # 1, Lombard, Illinois. You can reach out to her office (for appointments etc.) via phone at (630) 527-3645.

Ms Jacqueline Marie Nichols is licensed to practice in Illinois (license number 209.024109) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1821752494.

Contact Information

Ms Jacqueline Marie Nichols,
130 S Main St # 1,
Lombard, IL 60148-2670
(630) 527-3645
Not Available

Map and Direction




Provider's Profile

Full NameMs Jacqueline Marie Nichols
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location130 S Main St # 1, Lombard, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ms Jacqueline Marie Nichols graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1821752494
  • Provider Enumeration Date: 10/28/2021
  • Last Update Date: 10/28/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 8628469590
  • Enrollment ID: I20220104000227

Medical Identifiers

Medical identifiers for Ms Jacqueline Marie Nichols such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821752494NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209.024109 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Elmhurst Memorial HospitalElmhurst, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Endeavor Health Medical Group21633346993022
Elmhurst Memorial Hospital357745800974

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Jacqueline Marie Nichols allows following entities to bill medicare on her behalf.
Entity NameEdward Health Ventures
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962452912
PECOS PAC ID: 4284531484
Enrollment ID: O20031216000616
Entity NameElmhurst Memorial Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548306343
PECOS PAC ID: 3577458009
Enrollment ID: O20040216000346
Entity NameEdward Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013969013
PECOS PAC ID: 0042108110
Enrollment ID: O20040309001279
Entity NameEndeavor Health Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497701882
PECOS PAC ID: 2163334699
Enrollment ID: O20040524000118

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Jacqueline Marie Nichols is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Jacqueline Marie Nichols,
506 E Highland Ave,
Mount Prospect, IL 60056-2138

Ph: (847) 807-9116		Ms Jacqueline Marie Nichols,
130 S Main St # 1,
Lombard, IL 60148-2670

Ph: (630) 527-3645

Reviews and Comments


Nurse Practitioner Nurses in Lombard, IL

Teena Aikara Joseph, MSN, APN, FNP-C
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Medicare: Medicare Enrolled
Practice Location: 130 S Main St Ste 203, Lombard, IL 60148
Phone: 630-627-3700    
Elizabeth Fleming,
Nurse Practitioner
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Practice Location: 580 Waters Edge Ste 100, Lombard, IL 60148
Phone: 630-495-8484    
Bien Flores Mendoza, MSN
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Medicare: Not Enrolled in Medicare
Practice Location: 548 S Elizabeth St, Lombard, IL 60148
Phone: 360-488-7882    
Aleksandra Vargas, FNP-BC
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 1s072 Luther Ave, Lombard, IL 60148
Phone: 630-247-8877    Fax: 630-576-0580
Philomina O Okegbu,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 244 E Roosevelt Rd, Lombard, IL 60148
Phone: 773-690-3917    
Brittney Douglas, MSN, APRN, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 244 E Roosevelt Rd, Lombard, IL 60148
Phone: 224-365-8112    
Ms. Reeja Robert Puthenveetil, FNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2340 S Highland Ave Ste 230, Lombard, IL 60148
Phone: 630-932-2040    Fax: 630-932-1513

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.