Individual provider Active NPI

Jordan Danielle Obos, RN

  • Registered Nurse
  • McHenry, IL
National Provider Identifier
1023912854
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041490946 Issued in IL
Practice address
2507 N Richmond Rd
McHenry, IL 60051-5407
Phone
(815) 344-2300
NPI assigned
Oct 5, 2026
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041490946 IL Primary
Registered Nurse 163W00000X 252656 WI

Addresses

Primary practice location

2507 N Richmond Rd
McHenry, IL 60051-5407

Mailing address

2507 N Richmond Rd
McHenry, IL 60051-5407
Phone (815) 344-2300

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041490946ILMDRegistered Nurse
252656WIMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1023912854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600515407",
            "telephone_number": "815-344-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 N RICHMOND RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600515407",
            "telephone_number": "815-344-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBOS",
        "first_name": "JORDAN",
        "middle_name": "DANIELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041490946",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "252656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.