Judson University

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JUDSON UNIVERSITY

Practice address

1151 N State St
Elgin, IL 60123-1404

Phone

(847) 628-2464

Fax

(847) 628-2044

NPI assigned

Sep 19, 2017

Organization subpart

No

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

Authorized official

Name

Carol Didominicis, LCSW

Title

Clinical Supervisor

Phone

(847) 628-2464

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sara Brunsting, LPC

  • Professional Counselor
  • Elgin, IL
  • NPI 1124658893
  NPD (past)
• Maria K Rim

  • Clinical Social Worker
  • Elgin, IL
  • NPI 1376033241
  NPD (past)

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1356860571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231404",
            "telephone_number": "847-628-2464",
            "fax_number": "847-628-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231404",
            "telephone_number": "847-628-2464",
            "fax_number": "847-628-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDSON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "DIDOMINICIS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "847-628-2464",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil T Joseph, MD
• Samantha Josh
• Divyang A Joshi, MD
• Manindri Joslin, PHD
• Joel Jossart
• Anne Marie Jump
• Mallory Kaitlyn Jump
• Mary Jung, MD
• Michael E Jung, D.C.
• Sadie Jurkovic

• Community/Behavioral Health Agency in Elgin, IL
• Providers in Elgin, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.