Active NPI
Jaclyn Bobinski, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1104581255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180013934
- Practice address
- 4840 W Byron St
Chicago, IL 60641-2778 - Phone
- (773) 573-2834
- NPI assigned
- Nov 3, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180013934 | IL | Primary |
Addresses
Primary practice location
4840 W Byron St
Chicago, IL 60641-2778
Mailing address
214 Tanglewood Dr
Elk Grove Village, IL 60007-1714
Phone (484) 477-5203
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 |
|---|---|---|---|
| 180013934 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1104581255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 TANGLEWOOD DR",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600071714",
"telephone_number": "484-477-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4840 W BYRON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606412778",
"telephone_number": "773-573-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBINSKI",
"first_name": "JACLYN",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180013934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Bobby E. Wright Comprehensive Behavioral Health Center, Inc.
- Bobby E. Wright Comprehensive Behavioral Health Center, Inc.
- Bobby Wright Behavioral Health Institute
- Christine Bobek
- Michelle Ann Bobek, L/PTA
- Erica Louise Bobish, LCSW
- Jessica Anne Boblick-Uribe, LCSW, LICSW
- Jittaun Yvette Bobo
- Sonia Bobra, M.D.
- Rebecca Claire Bobrow, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.