Active NPI
Mary T Jennings, PSYD
- Psychologist
- Chicago, IL
National Provider Identifier
1164936910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071009644
- Practice address
- 1 E Superior St Ste 306
Chicago, IL 60611-2595 - Phone
- (312) 929-2172
- NPI assigned
- Nov 30, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071009644 | IL | Primary |
Addresses
Primary practice location
1 E Superior St Ste 306
Chicago, IL 60611-2595
Mailing address
1 E Superior St Ste 306
Chicago, IL 60611-2595
Phone (312) 929-2172
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071009644 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1164936910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 E SUPERIOR ST STE 306",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112595",
"telephone_number": "312-929-2172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 E SUPERIOR ST STE 306",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112595",
"telephone_number": "312-929-2172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "MARY",
"middle_name": "T",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071009644",
"primary": true
}
],
"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 Nov 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.