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Deactivated NPI 1578707584 Deactivated / Inactive NPI Male Practitioner

Dr. David Wayne Jackson , OD

Optometrist • Chicago, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Jackson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 22, 2009
NPI Deactivation Date August 05, 2019
Total Practice Duration ~10 Years of Practice (2009 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. David Jackson, OD was a registered Optometrist practicing in Chicago, IL. Throughout an active medical career spanning 10 years, Dr. Jackson provided care at the practice location at 6254 S PULASKI RD until profile deactivation on 2019-08-05.

Practice Location & Contact Primary Location

Practice Address

6254 S Pulaski Rd

Chicago, IL 606294610

Telephone 7735811515
Associated Practice Facility / Clinic
🏢 Midwest Eye Clinic, Inc Facility NPI 1669636270

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Chicago, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.6 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
633 Specialists

Practicing in Chicago, IL (2783 Statewide)

Telehealth Adoption Rate
0.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IL 046008452

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1356404248

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 05, 2019

Record deactivated on August 05, 2019

NPI Profile Active April 08, 2015

NPI status registered as active in NPPES database

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Updated Practice Location April 08, 2015

Registered at 6254 S PULASKI RD, CHICAGO, IL 606294610 (Tel: 7735811515)

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Updated Business Mailing Address April 08, 2015

Registered at 6254 S PULASKI RD, CHICAGO, IL 606294610 (Tel: 7735811515)

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Provider Name / Credentials Updated April 08, 2015

Recorded as DAVID JACKSON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 08, 2015

Optometrist (License #046008452 in IL)

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Initial NPI Registration & Enumeration April 22, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578707584
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 22, 2009
Last Update: April 08, 2015
Deactivation Date: August 05, 2019

Mailing Address

6254 S Pulaski Rd

Chicago, IL 606294610

Phone: 7735811515

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.