MICHAEL JACKSON

On Hold
Details
Basic Information
Patient Record Number: JM561791
Date of Birth: 03/17/1953
Age: 72
Sex: N/A
SSN: N/A
Medicare Number: N/A
Contact Information
Mobile Phone: (312) 376-5080
Home Phone: N/A
Email: N/A
Emergency Contact: N/A
Emergency Phone: N/A
Last Seen: 12/07/2022
Address Information
221 E 60TH ST
3RD FLR
Chicago, IL 60637
Coordinates: 41.7854403, -87.6195027
Home Health Nurse
WELLSPRING HEALTHCARE
Phone: 630-968-7770
Fax: 630-968-7777
Status: Active
Medicare Part B Deductible

No deductible information available

Annual Wellness Visit

No wellness visit information available

Appointments
Certifications
10/22/2022 - 12/20/2022
Expired
SOC: 08/23/2022
Discharge History
View All

No discharge history

Patient Actions
Appointment History
Loading appointment history...
485 Certifications
Start Date End Date Status Type Notes Actions
10/22/2022 12/20/2022 Expired N/A SOC: 08/23/2022
Patient On Hold
Hold Reason: no poc 2025
Hold Since: 07/03/2025
Hold Until: Indefinite