NPIMap

Organization Active NPI

Retake on Life

Doing business as Jamillah Davis

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1295379279
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
RETAKE ON LIFE
Doing business as
Jamillah Davis
Practice address
9415 S Western Ave
Chicago, IL 60643-6700
Phone
(773) 998-7848
NPI assigned
Nov 1, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Authorized official

Name
Jamillah Davis, LCPCNPI 1154714707
Title
Licensed Clin Prof Counselor
Phone
(773) 998-7848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

9415 S Western Ave
Chicago, IL 60643-6700

Mailing address

8008 S Loomis Blvd
Chicago, IL 60620-3828
Phone (773) 998-7848

Other names 1

  • Jamillah Davis Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1295379279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 S LOOMIS BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606203828",
            "telephone_number": "773-998-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606436700",
            "telephone_number": "773-998-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETAKE ON LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMILLAH",
        "authorized_official_title_or_position": "LICENSED CLIN PROF COUNSELOR",
        "authorized_official_telephone_number": "773-998-7848",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamillah Davis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 1, 2019; 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.