Active NPI
Jamillah Davis
- Professional Counselor
- Chicago, IL
National Provider Identifier
1154714707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180011249
- Practice address
- 433 W Harrison St Ste 1104
Chicago, IL 60699-3916 - Phone
- (773) 998-7848
- NPI assigned
- Mar 6, 2015
- Last updated
- Jan 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180011249 | IL | Primary |
| Professional Counselor | 101YP2500X | 178006542 | IL |
Addresses
Primary practice location
433 W Harrison St Ste 1104
Chicago, IL 60699-3916
Mailing address
8008 S Loomis Blvd
Chicago, IL 60620-3828
Phone (773) 998-7848
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 |
|---|---|---|---|
| 178006542 | IL | MD | Professional Counselor |
| 180011249 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Retake on Life | Professional | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1154714707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8008 S LOOMIS BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606203828",
"telephone_number": "773-998-7848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 W HARRISON ST STE 1104",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606993916",
"telephone_number": "773-998-7848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JAMILLAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-06",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180011249",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178006542",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.