MS. JACKIE LYNN BOUSEK (NPI# 1063818649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063818649 |
| Entity Type | Individual |
| Full Name | MS. JACKIE LYNN BOUSEK |
| Credential | ATR, LCPC |
| Practice Address |
2302 W North Ave #1e Chicago IL 60647-6260 |
| Practice Telephone | 7083208992 |
| Mailing Telephone | 7083208992 |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2016-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180010087 | IL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
178.009703 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2302 W NORTH AVE #1E |
| City | CHICAGO |
| State | IL |
| Zip Code | 60647-6260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710024187 | Nicole Meyer Klarich | Counselor | 2302 W North Ave, Suite 1e, Chicago, IL 60647-6260 | 2007-02-01 |
| 1568921385 | Elexa O'donnell | Social Worker | 2302 W North Ave, Chicago, IL 60647-6260 | 2019-03-19 |
| 1235502998 | Brandy M Jones | Counselor | 2302 W North Ave, 1e, Chicago, IL 60647-6260 | 2015-11-03 |
| 1316322811 | Bailey and Associates, Counseling & Psychotherapy | Counselor | 2302 W North Ave, #1e, Chicago, IL 60647-6260 | 2015-07-25 |
| 1447654520 | Katharine Marie Kiehn | Counselor | 2302 W North Ave, Chicago, IL 60647-6260 | 2014-10-17 |
| 1255685145 | Manya Elizabeth Treece | Social Worker | 2302 W North Ave, Chicago, IL 60647-6260 | 2012-10-31 |
| 1376899799 | Andrew R Wall | Counselor | 2302 W North Ave, Unit 1e, Chicago, IL 60647-6260 | 2012-08-03 |
| 1063793677 | Marie Naumann | Psychologist | 2302 W North Ave, Chicago, IL 60647-6260 | 2011-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1700322922 | Lumen Optical Illinois 4, LLC | Optometrist | 2420 N Elston, Bucktown, IL 60647 | 2017-01-11 |
| Find all providers in zip 60647 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| 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.