Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Cooley

Individual provider Certified Registered Nurse Anesthetist · NPI 1104231422

Jackie Cooley is a Certified Registered Nurse Anesthetist (CRNA) in Springfield, Illinois. Qualified in 2014, 12 years ago. Practices with Memorial Medical Center, a 130-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014
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Practice location Address checks out

800 E Carpenter St
Springfield, IL 62702-5324
Phone: (217) 525-5643
Fax: (217) 544-2521
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209011614 (IL)

Record details

NPI number1104231422
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 25, 2014
Last updated in NPPESJune 25, 2014
Mailing address800 E Carpenter St, Springfield, IL 62702-5324

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Memorial Medical Center — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Springfield