Active NPI
Jordan Lorraine Shaffer
- Behavior Analyst
- Chicago, IL
National Provider Identifier
1275879892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 30 E Elm St
Apt 19a
Chicago, IL 60611-1042 - Phone
- (630) 908-0946
- NPI assigned
- Dec 31, 2012
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
30 E Elm St
Apt 19a
Chicago, IL 60611-1042
Mailing address
306 N. Kensington Ave
La Grange Park, IL 60526
Phone (312) 965-2997
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": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1275879892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 N. KENSINGTON AVE",
"city": "LA GRANGE PARK",
"state": "IL",
"postal_code": "60526",
"telephone_number": "312-965-2997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E ELM ST",
"address_2": "APT 19A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606111042",
"telephone_number": "630-908-0946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JORDAN",
"middle_name": "LORRAINE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"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 Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.