MJ
MICHAEL JACKSON
JM561791 · 03/17/1953 · Updated 04/10/2026
On Hold
Basic Information
| Patient Record Number: | JM561791 |
| Date of Birth: | 03/17/1953 |
| Age: | 73 |
| Sex: | male |
| SSN: | N/A |
| Medicare Number: | N/A |
| Last Updated: | 04/10/2026 05:29 PM |
Contact Information
| Mobile Phone: | (312) 376-5080 |
| Home Phone: | N/A |
| Email: | N/A |
| Emergency Contact: | N/A |
| Emergency Phone: | N/A |
| Last Seen: | Never |
| Provider: | Kalpana Mutyala |
Address Information
221 E. 60TH ST
3RD FLR
Chicago, IL 60637 Coordinates: 41.7854403, -87.6195027
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
Discharge History
View AllNo discharge history
Patient Actions
Appointment History
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Patient Documents
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Total Claims-
Total Paid-
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Payment RateRemittance Claims
| Service Date | Procedure | Provider | Billed | Allowed | Paid | Status | Remit Date |
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Patient On Hold
Hold Reason: no poc 2025
Hold Since: 07/03/2025
Hold Until: Indefinite