MR. JACOB JONATHAN WHITE (NPI# 1265818884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265818884 |
| Entity Type | Individual |
| Full Name | MR. JACOB JONATHAN WHITE |
| Credential | PA |
| Practice Address |
5645 W Addison St Chicago IL 60634-4403 |
| Practice Telephone | 7732827000 |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085005589 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194289892 | Jacob White | Specialist/Technologist | 580 Commonwealth Ave Unit 501, Boston, MA 02215-2509 | 2019-01-27 |
| 1386969210 | Jacob White | Radiology | 1264 Saint Nicholas Ave, New York, NY 10033-7263 | 2010-04-04 |
| 1689217044 | Jacob White | Pharmacist | 19300 Sw 65th Ave, Tualatin, OR 97062-7706 | 2019-10-17 |
| 1790343382 | Jacob White | Behavior Technician | 1130 Tabb St, Norfolk, VA 23504-3434 | 2019-05-30 |
| 1295391944 | Jacob White IIi | Peer Specialist | 16 W Long St, Columbus, OH 43215-2815 | 2019-05-17 |
| 1548735079 | Jacob Vaughn White | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-10-11 |
| 1003304387 | Jacob Richard White | Student in an Organized Health Care Education/Training Program | 3420 Fifth Avenue, Pittsburgh, PA 15213 | 2018-04-23 |
| 1073909719 | Jacob Matthew White | Counselor | 213 W Monroe Ave, Suite Q, Lowell, AR 72745-9451 | 2015-04-09 |
| 1831506351 | Jacob Christopher White | Psychiatry & Neurology | 413 N Allumbaugh St Ste 101, Boise, ID 83704-9219 | 2014-07-16 |
| 1205118569 | Jacob Garrett White | Social Worker | 859 Willard St, Quincy, MA 02169 | 2011-09-13 |
| Street Address |
5645 W ADDISON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60634-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845763 | Our Lady of The Resurrection Medical Center | Emergency Medicine | 5645 W Addison St, Chicago, IL 60634-4403 | 2005-07-19 |
| 1740809797 | Nicholas Donald Charmelo | Registered Nurse | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-04-09 |
| 1528695814 | Ana Bulaja | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-03-25 |
| 1669008702 | Jeremy Blauser | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2020-03-20 |
| 1598306870 | Sss Pathology Services Pllc | Pathology | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-10-08 |
| 1639737851 | Akhter U Patel | Nurse Practitioner | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-06-03 |
| 1457916124 | Jaclyn Novak | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-05-07 |
| 1962977421 | Ashley Fisher | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-10-10 |
| 1093211153 | Brandee Joy Grenda | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-04-05 |
| 1639687825 | Amy M Boettcher | Nurse Anesthetist, Certified Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987333 | Alejandra Carrera | Student in an Organized Health Care Education/Training Program | 6417 W Irving Park Rd., Chicago, IL 60634 | 2019-11-25 |
| 1861977456 | Virtue Counseling Center | Counselor | 2904 N Parkside, Chicago, IL 60634 | 2018-09-28 |
| 1770931255 | Dynamic Transport Solutions LLC | Non-emergency Medical Transport (VAN) | 6109 W. Barry, Chicago, IL 60634 | 2016-05-25 |
| 1104284710 | Ez Dental | Dental Laboratory | 5621 W.montrose Avenue, Chicago, IL 60634 | 2016-02-10 |
| 1285075432 | Chicago Medical Transportation | Non-emergency Medical Transport (VAN) | 3033 N. Nordica Ave., Chicago, IL 60634 | 2013-07-16 |
| 1083985725 | Maria C. Rodriguez | Lactation Consultant, Non-RN | 6216 W. School St., Chicago, IL 60634 | 2012-01-25 |
| 1295066827 | Angie Harris | Occupational Therapist | 3339 N. Octavia, Chicago, IL 60634 | 2010-01-21 |
| 1205169802 | Belmont Dental P.C. | Dentist | 5611 W. Belmont Ave., Chicago, IL 60634 | 2009-09-14 |
| 1568605178 | Henry Biskup | Radiologic Technologist | 3105 N. Austin Ave., Chicago, IL 60634 | 2009-04-13 |
| 1306086624 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3615 N. Central Ave, Chicago, IL 60634 | 2009-02-26 |
| Find all providers in zip 60634 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1245858117 | Emily Victoria Headley | Physician Assistant | 1431 N Western Ave Ste 134, Chicago, IL 60622-1797 | 2020-07-08 |
| 1548884547 | Crystal Afua Amoah | Physician Assistant | 1665 N Orchard St Apt 104, Chicago, IL 60614-5385 | 2020-06-04 |
| 1841814274 | Zubair Aslam Khan | Physician Assistant | 3037 W Wilson Ave Apt 2w, Chicago, IL 60625-4345 | 2020-06-01 |
| 1659991818 | Taylor Nicole Anderson | Physician Assistant | 25 W Randolph St Apt 603, Chicago, IL 60601-3514 | 2020-04-17 |
| 1720616444 | Melanie Doretti | Physician Assistant | 3052 N Seminary Ave Apt 2r, Chicago, IL 60657-6788 | 2020-03-29 |
| 1154958544 | Joerissa Gearlds | Physician Assistant | 5645 W Addison St Rm 353, Chicago, IL 60634-4403 | 2020-03-25 |
| 1932736816 | Taylor Evan Fisher | Physician Assistant | 3033 N Sheridan Rd Apt 301, Chicago, IL 60657-5578 | 2020-03-23 |
| 1285260844 | Krista A Saum | Physician Assistant | 661 W Sheridan Rd Apt 601, Chicago, IL 60613-3311 | 2020-03-16 |
| 1386278430 | Adara Simonelli | Physician Assistant | 6317 S Lorel Avenue, Chicago, IL 60638 | 2020-02-27 |
| 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.