Uptown Dui Services

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

302F00000X Issued in IL

Legal business name

UPTOWN DUI SERVICES

Practice address

1525 E 53Rd St Ste 411
Chicago, IL 60615-4530

Phone

(312) 451-5184

Fax

(708) 896-6580

NPI assigned

Oct 16, 2016

Organization subpart

No

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

Authorized official

Name

Paul Fitzgerald Jordan, CADC, MISA I, DUI

Title

Dui / Treatment Provider

Phone

(312) 451-5184

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476576000000",
    "number": "1124579073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST STE 411",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154530",
            "telephone_number": "312-451-5184",
            "fax_number": "708-896-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST STE 411",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154530",
            "telephone_number": "312-451-5184",
            "fax_number": "708-896-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN DUI SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-16",
        "last_updated": "2016-10-16",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "FITZGERALD",
        "authorized_official_title_or_position": "DUI / TREATMENT PROVIDER",
        "authorized_official_telephone_number": "312-451-5184",
        "authorized_official_credential": "CADC, MISA I, DUI"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "302F00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Chicago, IL
• Providers in Chicago, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2016; 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.