Active NPI
Jason Ryan Weiss
- Professional Counselor
- Chicago, IL
National Provider Identifier
1013674043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1708017556
- Practice address
- 180 N Michigan Ave Ste 1040
Chicago, IL 60601-7421 - Phone
- (312) 346-5156
- Fax
- (312) 284-6088
- NPI assigned
- Nov 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1708017556 | IL | Primary |
Addresses
Primary practice location
180 N Michigan Ave Ste 1040
Chicago, IL 60601-7421
Mailing address
21509 W Barbara CT
Kildeer, IL 60047-8611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1708017556 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637712000000",
"number": "1013674043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21509 W BARBARA CT",
"city": "KILDEER",
"state": "IL",
"postal_code": "600478611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 N MICHIGAN AVE STE 1040",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017421",
"telephone_number": "312-346-5156",
"fax_number": "312-284-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "JASON",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-24",
"last_updated": "2021-11-24",
"certification_date": "2021-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "1708017556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.