MJ

MICHAEL JACKSON

JM561791 · 03/17/1953 · Updated 03/09/2026
On Hold PF
Basic Information
Patient Record Number: JM561791
Date of Birth: 03/17/1953
Age: 72
Sex: male
SSN: N/A
Medicare Number: N/A
Last Updated: 03/09/2026 07:12 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: 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

Certifications
10/22/2022 - 12/20/2022
Expired
SOC: 08/23/2022
Discharge History
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No discharge history

Patient Actions
Appointment History
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485 Certifications
Start Date End Date Status Type Notes Actions
10/22/2022 12/20/2022 Expired N/A SOC: 08/23/2022
Patient Documents
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Practice Fusion Link
Linked
PF GUID: f30b4544-29ce-4baa-a...
Linked At: 02/16/2026 14:48
Stored Transcripts

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Encounter History
Date Type Provider Chief Complaint Status Actions
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Total Claims

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Total Paid

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Denials

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Payment Rate
Remittance 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