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Colleen M Jackson

Counselor β€’ Chicago, IL

Active NPI 1699317263 Individual Practitioner Female Practitioner
Practice location in NPPES

1136 S Delano Ct W Ste B201
Chicago, IL 606053734

Call 7088455500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1136 S Delano Ct W Ste B201

Chicago, IL 606053734

Telephone 7088455500
Fax 7088455505
Organization at the Same NPPES Address or Phone
True Hands Home Health Care Facility NPI 1922544626

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Chicago, IL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Chicago and Illinois

547 active clinicians are listed under Counselor with a practice address in Chicago, IL (3,824 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Chicago

1.8% of these 547 clinicians have the CMS telehealth indicator.

2.9% of these 547 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES IL 178015305

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Secondary Practice Locations

1401 W Hollywood Ave

Chicago, IL 606604214

Phone: 7088455500

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Maria Blackburn , MSW

Social Worker - Clinical

NPI 1699138016

Master of Social Work

Laura Goossens

Social Worker - Clinical

NPI 1467833814
Heather Mulcahy

Social Worker - Clinical

NPI 1356884233
Shawna Sapp

Social Worker - Clinical

NPI 1619356540

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
βœ…
NPI Profile Active October 15, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 15, 2019

Registered at 1136 S DELANO CT W STE B201, CHICAGO, IL 606053734 (Tel: 7088455500)

πŸ“
Business Mailing Address (Initial Record) October 15, 2019

Registered at 15127 S 73RD AVE STE G, ORLAND PARK, IL 604623425 (Tel: 7088455500)

🏒
Secondary Practice Location Registered October 15, 2019

Additional practice office at 1401 W Hollywood Ave, Chicago, IL 606604214

πŸ‘€
Provider Name / Credentials (Initial Record) October 15, 2019

Recorded as COLLEEN JACKSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2019

Counselor (license number reported to NPPES: IL 178015305)

🟒
Initial NPI Registration & Enumeration October 15, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1699317263
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 15, 2019
Last Update: October 15, 2019
Sole Proprietor: No

Mailing Address

15127 S 73rd Ave Ste G

Orland Park, IL 604623425

Phone: 7088455500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.