Jacksoneye SC
NPI 1073669834ActiveOrganization· Ophthalmology· Lake Villa, IL
Ophthalmology in Lake Villa, Illinois, registered in NPPES in January 2007. The authorized official on file is Mitchell Alin Jackson, MD, Ceo Owner. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1073669834 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 26, 2007 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology Primary | 207W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (WI) |
|---|
Other Ophthalmology providers in Lake Villa
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