Individual provider Active NPI

Karen Leslie Jaffe, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1154357044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
71-2699 Issued in IL
Practice address
30 North Michigan Avenue
Suite 607
Chicago, IL 60602-6060
Phone
(312) 263-1780
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 71-2699 IL Primary

Addresses

Primary practice location

30 North Michigan Avenue
Suite 607
Chicago, IL 60602-6060

Mailing address

30 North Michigan Avenue
Suite 607
Chicago, IL 60602-6060
Phone (312) 263-1780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060920000253 IL Practitioner - Clinical Psychologist 6002811320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25 E Washington St
Suite 1502
Chicago, IL 60602-1849
Phone (312) 263-1780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71-2699ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karen L. Jaffe Psy.D. LTD Clinical CurrentSince May 1, 2006 Accepting new patients

Locations

30 N Michigan Ave
Ste 607
Chicago, IL 60602
Phone (312) 263-1780

25 E Washington St
Ste 1502
Chicago, IL 60602
Phone (312) 263-1780

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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154357044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTH MICHIGAN AVENUE",
            "address_2": "SUITE 607",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606026060",
            "telephone_number": "312-263-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTH MICHIGAN AVENUE",
            "address_2": "SUITE 607",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606026060",
            "telephone_number": "312-263-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "KAREN",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71-2699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.