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

Jackie Ta, DO

Individual provider Anesthesiology Physician · NPI 1649652165

Jackie Ta, DO is an Anesthesiology in Chicago, Illinois. Qualified in 2015, 11 years ago. Practices with Lifebridge Anesthesia Associates LLC, a 109-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2015
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone: (703) 342-9546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 125067630 (IL)

Record details

NPI number1649652165
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 20, 2015
Last updated in NPPESJune 20, 2015

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Lifebridge Anesthesia Associates Llc — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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