Active NPI
Jasseena Bince Veliyathumalil, NP
- Family Nurse Practitioner
- Chicago, IL
National Provider Identifier
1023360781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209008781
- Practice address
- 1901 W Harrison St
Chicago, IL 60612-3714 - Phone
- (847) 770-2598
- NPI assigned
- Oct 4, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209008781 | IL | Primary |
Addresses
Primary practice location
1901 W Harrison St
Chicago, IL 60612-3714
Mailing address
314 N Marcella Rd
Mount Prospect, IL 60056-2615
Phone (847) 759-9973
Other names 1
- Miss Jasseena Clement
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jveliyathum@direct.ccprovider.org | Direct | Cook County |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209008781 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients |
Locations
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600
Interoperability endpoints
- jveliyathum@direct.ccprovider.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1821385170
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1023360781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 N MARCELLA RD",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600562615",
"telephone_number": "847-759-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 W HARRISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123714",
"telephone_number": "847-770-2598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELIYATHUMALIL",
"first_name": "JASSEENA",
"middle_name": "BINCE",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-04",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209008781",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jveliyathum@direct.ccprovider.org",
"affiliation": "Y",
"affiliationName": "Cook County",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1969 W. Ogden Ave.",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JASSEENA",
"last_name": "CLEMENT",
"prefix": "MISS",
"code": "5",
"type": "Other Name"
}
]
}
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 May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.