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Dr. Petrina Jackson , DC

Chiropractor β€’ Hazel Crest, IL

Active NPI 1295377240 Individual Practitioner Female Practitioner
Practice location in NPPES

17516 E Carriageway Dr Ste B
Hazel Crest, IL 604292079

Call 7082606699 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

17516 E Carriageway Dr Ste B

Hazel Crest, IL 604292079

Telephone 7082606699
Fax 7089144393
Organization at the Same NPPES Address or Phone
Trio Chiropractic And Wellness Center Sc Facility NPI 1730777905

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

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

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 Hazel Crest and Illinois

1 active clinicians are listed under Chiropractor with a practice address in Hazel Crest, IL (4,525 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

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

Self-certified to NPPES: 2023-01-05
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

License # reported to NPPES IL 038.013330

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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

Career & Practice History Timeline

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

10 Historical Events
πŸ“
Updated Business Mailing Address January 05, 2023

Registered at 17516 E CARRIAGEWAY DR STE B, HAZEL CREST, IL 604292079 (Tel: 7089144445)

πŸ“
Updated Practice Location April 27, 2022

Registered at 17516 E CARRIAGEWAY DR STE B, HAZEL CREST, IL 604292079 (Tel: 7082606699)

πŸ“
Updated Practice Location November 06, 2020

Registered at 4143 SAUK TRL, RICHTON PARK, IL 604711253 (Tel: 8448362867)

πŸ“
Updated Business Mailing Address November 06, 2020

Registered at 335 E GENEVA RD # 3042, CAROL STREAM, IL 601882438 (Tel: 6308039679)

βœ…
NPI Profile Active October 10, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 10, 2019

Registered at 1283 W DUNDEE RD, BUFFALO GROVE, IL 600894009 (Tel: 8476329919)

πŸ“
Business Mailing Address (Initial Record) October 10, 2019

Registered at 4319 CHESAPEAKE DR APT 2C, AURORA, IL 605047131 (Tel: 6308039679)

πŸ‘€
Provider Name / Credentials (Initial Record) October 10, 2019

Recorded as PETRINA JACKSON, DC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2019

Chiropractor (license number reported to NPPES: IL 038.013330)

🟒
Initial NPI Registration & Enumeration October 10, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1295377240
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2019
Last Update: January 05, 2023
Sole Proprietor: No

Mailing Address

17516 E Carriageway Dr Ste B

Hazel Crest, IL 604292079

Phone: 7089144445

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.