Organization Active NPI

Jeff Palacios, MD, LLC

  • Psychiatry Physician
  • Northbrook, IL
National Provider Identifier
1336709260
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JEFF PALACIOS, MD, LLC
Practice address
60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone
(224) 306-1879
Fax
(224) 205-3757
NPI assigned
Jun 13, 2019
Last updated
Jun 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Authorized official

Name
Jeffrey Palacios, MD
Title
President
Phone
(224) 306-1879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

60 Revere Dr Ste 100
Northbrook, IL 60062-1590

Mailing address

PO Box 506
Northbrook, IL 60065-0506
Phone (224) 306-1879

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1336709260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650506",
            "telephone_number": "224-306-1879",
            "fax_number": "224-205-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "224-306-1879",
            "fax_number": "224-205-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF PALACIOS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "PALACIOS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-306-1879",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.