Active NPI
Jason A Carman, DNP
- Family Nurse Practitioner
- Crystal Lake, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209000227
- Practice address
- 360 Station Dr
Crystal Lake, IL 60014 - Phone
- (815) 338-6600
- Fax
- (815) 455-8044
- NPI assigned
- Jul 15, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209000227 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209000227 | IL | Primary |
Addresses
Primary practice location
360 Station Dr
Crystal Lake, IL 60014
Mailing address
360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 338-6600
Other practice location 1
1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 843-2000
Other practice location 2
1925 Huntley Rd
West Dundee, IL 60118-9301
Phone (815) 338-6600
Other practice location 3
10350 Haligus Rd
Huntley, IL 60142-9545
Phone (815) 338-6600
Other practice location 4
2507 N Richmond Rd
McHenry, IL 60051-5407
Phone (815) 338-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209000227 | Other | IL | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3415 | WI | MD | Mental Health Counselor |
| 209000227 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Physicians Immediate Care North Chicago LLC | Current | Accepting new patients | |
| Greater Elgin Emergency Specialists LTD | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000
360 Station Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 455-1800
360 Station Dr
Crystal Lake, IL 60014
Phone (815) 477-7350
2490 Bushwood Dr
Elgin, IL 60124
Phone (224) 293-5200
11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300
10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
-
- Emergency Medicine Physician
- Elgin, IL
- NPI 1134152366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541116800000",
"number": "1174522825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147978",
"telephone_number": "815-338-6600",
"fax_number": "815-455-8044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60014",
"telephone_number": "815-338-6600",
"fax_number": "815-455-8044"
}
],
"practiceLocations": [
{
"address_1": "1555 Barrington Rd",
"address_purpose": "LOCATION",
"city": "Hoffman Estates",
"state": "IL",
"postal_code": "601691019",
"country_code": "US",
"telephone_number": "847-843-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1925 Huntley Rd",
"address_purpose": "LOCATION",
"city": "West Dundee",
"state": "IL",
"postal_code": "601189301",
"country_code": "US",
"telephone_number": "815-338-6600",
"fax_number": "847-426-5162",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10350 Haligus Rd",
"address_purpose": "LOCATION",
"city": "Huntley",
"state": "IL",
"postal_code": "601429545",
"country_code": "US",
"telephone_number": "815-338-6600",
"fax_number": "847-802-7112",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2507 N Richmond Rd",
"address_purpose": "LOCATION",
"city": "McHenry",
"state": "IL",
"postal_code": "600515407",
"country_code": "US",
"telephone_number": "815-338-6600",
"fax_number": "815-385-3255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARMAN",
"first_name": "JASON",
"middle_name": "A",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-15",
"last_updated": "2018-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209000227",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209000227",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "209000227",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.