JASON CLARK (NPI# 1033727425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033727425 |
| Entity Type | Individual |
| Full Name | JASON CLARK |
| Practice Address |
2451 N Lincoln Ave Side 2 Chicago IL 60614-4170 |
| Mailing Address |
1166 Silverwood Ct Apt D1 Wheeling IL 60090-2431 |
| Practice Telephone | 7734696675 |
| Mailing Telephone | 8479511961 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548695489 | Jason S. Clark | Veterinarian | 11800 Capital Way, Louisville, KY 40299-6332 | 2013-09-11 |
| 1346201431 | Jason Drew Clark | Dentist | 7810 Providence Rd, Suite 100, Charlotte, NC 28226-2987 | 2006-03-29 |
| 1306197348 | Jason Clark | Nurse Anesthetist, Certified Registered | 620 Skyline Drive, Jackson, TN 38301 | 2012-10-01 |
| 1568711513 | Jason E Clark | Case Management | 4615 Philips Highway, Jacksonville, FL 32207-7265 | 2012-09-06 |
| 1699024695 | Jason M Clark | Optometrist | 101 Conley Rd, Columbia, MO 65201-6465 | 2012-09-05 |
| 1457632705 | Jason Clark | Physical Therapy Assistant | 1001 Giesau Dr, Ontonagon, MI 49953-1454 | 2011-08-31 |
| 1184912883 | Jason Clark | Pharmacist | 3021 Reidville Rd, Spartanburg, SC 29301-5643 | 2011-07-14 |
| 1508150301 | Jason Clark | Occupational Therapist | 140 Technology Ln, Johnson City, TN 37604-2004 | 2011-06-09 |
| 1902101959 | Jason Andrew Clark | Nurse Anesthetist, Certified Registered | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2011-01-24 |
| 1134448525 | Jason D Clark | Orthopaedic Surgery | 480 E Jefferson St, Suite B, Butler, PA 16001-4780 | 2010-05-25 |
| Street Address |
2451 N LINCOLN AVE SIDE 2 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-4170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780602 | Saba Aqel | Counselor | 107 W Van Buren St Ste 215, Chicago, IL 60605-1054 | 2020-11-05 |
| 1538768155 | Angelicare LLC | Counselor | 6650 N Northwest Hwy Ste 215, Chicago, IL 60631-1363 | 2020-10-23 |
| 1013516145 | Modern Soul Therapy LLC | Counselor | 2000 N Racine Ave Ste 2160, Chicago, IL 60614-4045 | 2020-10-20 |
| 1477151942 | Mansukh Sandhu | Counselor | 8765 W Higgins Rd Ste 450, Chicago, IL 60631-4172 | 2020-10-15 |
| 1881291920 | Freddy Reyes | Counselor | 931 W Leland Ave Apt 405, Chicago, IL 60640-6611 | 2020-10-01 |
| 1508463704 | Tynisha Jointer | Counselor | 7710 S Saint Lawrence Ave, Chicago, IL 60619-2925 | 2020-10-01 |
| 1851908206 | Manqual Chambers | Counselor | 2801 S King Dr, Chicago, IL 60616-2949 | 2020-09-29 |
| 1184231672 | Francesca Cottone | Counselor | 1616 N Nordica Ave, Chicago, IL 60707-4317 | 2020-09-28 |
| 1952916322 | Elle Skelton | Counselor | 2219 N Seeley Ave Apt 3f, Chicago, IL 60647-3363 | 2020-09-13 |
| 1437764305 | Donita M Lester | Counselor | 7022 S South Shore Dr Apt 214, Chicago, IL 60649-2229 | 2020-09-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.