Individual provider Active NPI

Jacob Roayne Loer

  • Counselor
  • Glen Ellyn, IL
National Provider Identifier
1255267589
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.032765 Issued in IL
Practice address
999 N Main St Ste 103
Glen Ellyn, IL 60137-3572
Phone
(630) 480-9188
NPI assigned
Jun 23, 2026
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.032765 IL Primary

Addresses

Primary practice location

999 N Main St Ste 103
Glen Ellyn, IL 60137-3572

Mailing address

999 N Main St Ste 103
Glen Ellyn, IL 60137-3572
Phone (630) 480-9188

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1255267589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N MAIN ST STE 103",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373572",
            "telephone_number": "630-480-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N MAIN ST STE 103",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373572",
            "telephone_number": "630-480-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOER",
        "first_name": "JACOB",
        "middle_name": "ROAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.032765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.