NPIMap

Organization Active NPI

Jessica Gebbink Associates, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Antioch, IL
National Provider Identifier
1356989990
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JESSICA GEBBINK ASSOCIATES, LLC
Practice address
884 Hillside Ave
Antioch, IL 60002-1226
Phone
(309) 287-7050
NPI assigned
Dec 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Jessica Gebbink, LCSWNPI 1063881266
Title
Owner
Phone
(309) 287-7050

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

884 Hillside Ave
Antioch, IL 60002-1226

Mailing address

943 Marshall St
Lake Geneva, WI 53147-1107
Phone (309) 287-7050

Other practice location 1

844 Hillside Avenue
Antioch, IL 60002-6000
Phone (309) 287-7050

National Provider Directory

National Provider Directory

Locations

N3072 State Road 67
Ste B
Lake Geneva, WI 53147

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1356989990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 MARSHALL ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471107",
            "telephone_number": "309-287-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 HILLSIDE AVE",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021226",
            "telephone_number": "309-287-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "844 Hillside Avenue",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "IL",
            "postal_code": "600026000",
            "country_code": "US",
            "telephone_number": "309-287-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JESSICA GEBBINK ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "GEBBINK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-287-7050",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.