Jingru Tan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.021398 Issued in IL

Practice address

1445 N Cleveland Ave Apt D
Chicago, IL 60610-1132

Phone

(312) 478-0452

NPI assigned

Jun 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessie Tan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1285200907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 N CLEVELAND AVE APT D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101132",
            "telephone_number": "312-478-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N CLEVELAND AVE APT D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101132",
            "telephone_number": "312-478-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "JINGRU",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "TAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Candice Ann Ang Tan, MMS, PA-C, RD
• Elana Tan, M.D.
• Frederick T Tan, M.D.
• Grace M Tan, PHARMD
• Jerica Tan
• Jinxiao Tan, LCSW
• Joyce Y Tan, PHARMD
• Julian Sy Tan, DO
• Jun Liang Tan
• Kizhel Granzon Tan, CSRS

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.