Shaukat Jamal, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Practice address

478 Pennsylvania Ave
Ste 101
Glen Ellyn, IL 60137-4436

Phone

(630) 545-2887

Fax

(630) 682-5276

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metropolitan Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1841460391
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1306830583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 PENNSYLVANIA AVE",
            "address_2": "STE 101",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374436",
            "telephone_number": "630-545-2887",
            "fax_number": "630-682-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 PENNSYLVANIA AVE",
            "address_2": "STE 101",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374436",
            "telephone_number": "630-545-2887",
            "fax_number": "630-682-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMAL",
        "first_name": "SHAUKAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02208490",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irish Eyes LLC
• Karine Ivy, LCPC
• J. Howard and Associates, Inc.
• Kristen A. Jacobs, MSW, LSW
• Judy Ann Jakuszewski, PHARMD.
• Walter G Janis, DDS
• Theresa Jansky, D.D.S.
• Jenna Hedglen-Smith, PSYD PLLC
• Jennifer Fell Counseling Services, LLC
• Jennifer Polizzi LCSW LLC

• Psychiatry Physician in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.