Individual provider Active NPI

Jason A Carman, DNP

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1174522825
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209000227 Issued in IL
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

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
209000227OtherILSTATE 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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3415WIMDMental Health Counselor
209000227ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Oct 26, 2020 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.

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

Verify at the official NPI Registry.