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

Jaclyn Leibforth

Individual provider Acute Care Nurse Practitioner · NPI 1356117253

Jaclyn Leibforth is a Nurse Practitioner in Chicago, Illinois. Qualified in 2022, 4 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2023

Practice location Address checks out

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone: (888) 824-0200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2160 S 1st Ave, Maywood, IL 60153-3328 — (888) 584-7888

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209.028063 (IL)

Record details

NPI number1356117253
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 30, 2023
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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