Jaclyn Leibforth, - Medicare Nurse Practitioner in Maywood, IL

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Jaclyn Leibforth, is a medicare enrolled "Nurse Practitioner - Acute Care" in Maywood, Illinois. Her current practice location is 2160 S 1st Ave, Maywood, Illinois. You can reach out to her office (for appointments etc.) via phone at (888) 584-7888.

Jaclyn Leibforth is licensed to practice in Illinois (license number 209.028063) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1356117253.

Contact Information

Jaclyn Leibforth,
2160 S 1st Ave,
Maywood, IL 60153-3328
(888) 584-7888
Not Available

Map and Direction




Provider's Profile

Full NameJaclyn Leibforth
GenderFemale
SpecialityNurse Practitioner - Acute Care
Location2160 S 1st Ave, Maywood, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356117253
  • Provider Enumeration Date: 11/30/2023
  • Last Update Date: 11/30/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1850734211
  • Enrollment ID: I20240213002201

Medical Identifiers

Medical identifiers for Jaclyn Leibforth such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356117253NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 209.028063 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jaclyn Leibforth allows following entities to bill medicare on her behalf.
Entity NameLoyola University Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336159961
PECOS PAC ID: 3779488903
Enrollment ID: O20031202000027

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaclyn Leibforth is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jaclyn Leibforth,
1242 W Huron St Apt 1,
Chicago, IL 60642-0036

Ph: () -		Jaclyn Leibforth,
2160 S 1st Ave,
Maywood, IL 60153-3328

Ph: (888) 584-7888

Reviews and Comments


Nurse Practitioner Nurses in Maywood, IL

Dr. Margaret Mary Naber, DNP, APRN, NNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2160 S 1st Ave, Bldg 101, Room 1752, Maywood, IL 60153
Phone: 708-216-9000    Fax: 708-216-6269
Ms. Victoria Anne Davidson-bell, APN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-6569    
Ijeoma Achebe, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-9000    
Margaret Merritt, DNP, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 888-584-7888    
Mrs. Camille Kidd Moses, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-8591    Fax: 708-218-8600
Lauren M Martin,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Maywood, IL 60153
Phone: 708-216-9000    
Nancy Pak, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2160 S 1st Ave, Ems 110, Maywood, IL 60153
Phone: 708-216-9000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.