JERRY L PRICE JR. (NPI# 1164912283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164912283 |
| Entity Type | Individual |
| Full Name | JERRY L PRICE JR. |
| Credential | MBA |
| Practice Address |
6412 27th St # At Berwyn IL 60402-2755 |
| Mailing Address |
6120 N Kenmore Ave Apt 2e Chicago IL 60660-2727 |
| Practice Telephone | 3128982831 |
| Mailing Telephone | 3128982831 |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669553293 | Jerry Allen Price II | Chiropractor | 3901 Fort Henry Dr, Kingsport, TN 37663-2025 | 2006-10-18 |
| 1033146576 | Jerry W. Price | Dentist | 104 Hospital Dr, Tarboro, NC 27886-2012 | 2006-06-28 |
| 1821053901 | Jerry Price Jr. | Nurse Anesthetist, Certified Registered | 2010 Barrington Ln, Villa Rica, GA 30180-6954 | 2006-04-20 |
| 1639262603 | Jerry G Price | Surgery | 401 W Hampden Pl, Ste 230, Englewood, CO 80110-2470 | 2006-10-02 |
| 1396774972 | Jerry L. Price | Emergency Medicine | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2006-07-03 |
| 1699727339 | Jerry T Price | Emergency Medicine | 1901 Tate Springs Rd, Emergency Dept., Lynchburg, VA 24501-1109 | 2006-05-17 |
| Street Address |
6412 27TH ST # AT |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-2755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227995 | Jaclyn Wallen | Counselor | 6501 Stanley Ave, Berwyn, IL 60402-3123 | 2020-08-28 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1104312149 | Annie Elizabeth Baker | Counselor | 465 Winston Way, Berwyn, PA 19312-1145 | 2018-07-02 |
| 1457872731 | Andrew Thomas Lee | Counselor | 6200 Cermak Rd Fl 2, Berwyn, IL 60402-2322 | 2017-06-27 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| 1255614228 | Ivone Gutierrez | Counselor | 3245 Grove Ave Ste 104, Berwyn, IL 60402-3475 | 2011-09-26 |
| 1770716805 | Terri K Treiman | Counselor | 6918 Windsor Ave # B, Berwyn, IL 60402-3334 | 2009-08-24 |
| 1962644104 | Elizabeth Ann Brown | Counselor | 6 Porteous Rd, Berwyn, PA 19312-1275 | 2009-04-02 |
| 1477711638 | Specialized Rehabilitation Services, Inc | Counselor | 1347 Cuyler Ave, 2nd Floor, Berwyn, IL 60402-1391 | 2008-05-23 |
| 1447850557 | Sigita Lukauskaite | Counselor | 6415 Stanley Ave, Berwyn, IL 60402-3130 | 2020-10-28 |
| Find all providers in BERWYN | ||||
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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.