Individual provider · Type 1 NPI
Matt Jackson, AGAC NP- BC
Nurse Practitioner · Chicago, IL
Practice location
676 N Saint Clair St Ste 650
Chicago, IL 60611-2929
Fax (312) 695-3644
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 209015073 (IL) |
| Acute Care Nurse Practitioner | 363LA2100X | 209.015073 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1619419793
Matt Jackson, AGAC NP- BC's National Provider Identifier is 1619419793, issued on Nov 7, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chicago, IL. The record was last updated on Jan 28, 2026.