Individual provider Active NPI

Svetlana Jardan

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1205480258
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2118 W Arthur Ave Apt 3W
Chicago, IL 60645-5527
Phone
(224) 703-5780
NPI assigned
Jul 29, 2019
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

2118 W Arthur Ave Apt 3W
Chicago, IL 60645-5527

Mailing address

2118 W Arthur Ave Apt 3W
Chicago, IL 60645-5527
Phone (224) 703-5780

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: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Sep 18, 2021 Accepting new patients
Sunnyside Therapy LLC Behavior Analyst Current Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

9700 Gross Point Rd
Skokie, IL 60076
Phone (847) 674-7210

Organizations & group practices 2

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1205480258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 W ARTHUR AVE APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455527",
            "telephone_number": "224-703-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 W ARTHUR AVE APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455527",
            "telephone_number": "224-703-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDAN",
        "first_name": "SVETLANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.