Jonathan Daniel Colen, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-110038 Issued in IL

Practice address

1600 W Walnut St FL 3
Jacksonville, IL 62650-1136

Phone

(217) 545-8000

Fax

(217) 479-5737

NPI assigned

Jul 19, 2006

Last updated

Nov 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989

  Psychiatry

  Medicare reassignment NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Center for Psychiatric Health

  • Psychiatry Physician
  • Jacksonville, IL
  • NPI 1063680239
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1336168012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST FL 3",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-545-8000",
            "fax_number": "217-479-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST FL 3",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-545-8000",
            "fax_number": "217-479-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEN",
        "first_name": "JONATHAN",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-110038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110038",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mickie Clark, COTA
• Jessica M Clement
• Kristine Ann Cockerill, R.PH.
• Beaux Cole, PHARM. D.
• Carrie S Cole, RN
• Michelle Colen, M.D.
• Collaborative Medical PLLC
• College Avenue Dental Sleep Appliances LTD.
• Community Living Options Inc (Campbell Court)
• Community Living Options Inc (Anna Terrace)

• Psychiatry Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.