Jodi M Fourt

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JODI M FOURT

Practice address

1530 N Randall Rd Ste 220
Elgin, IL 60123-7879

Phone

(224) 703-5595

NPI assigned

May 22, 2023

Last updated

May 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodi Fourt, PSYDNPI 1053662445

Title

Sole Proprietor/PSYD

Phone

(224) 703-5595

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jodi Fourt, PSYD

  • Clinical Psychologist
  • Roscoe, IL
  • NPI 1053662445
  Medicare reassignment NPD Authorized official
• Paul Douglas Fairbanks, LCPC / LPC

  • Mental Health Counselor
  • Rogersville, TN
  • NPI 1356748578

  IL, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1376235184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 CROSSVIEW CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565841",
            "telephone_number": "224-703-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N RANDALL RD STE 220",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237879",
            "telephone_number": "224-703-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODI M FOURT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "FOURT",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/PSYD",
        "authorized_official_telephone_number": "224-703-5595",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheree Jenkins
• Antonio Jimenez Jr., D.C.
• Ria Esperanza De Leon Jimenez, P.T.
• Yi Jin
• Jameel Aldwin O Joco, DPT
• Ellen Patricia Johnson
• Geraldine Anne Johnson, RN
• Jennifer Johnson, MHP
• John Barnette Johnson III, MS DC
• Matthew Joseph Johnson, D.P.M.

• Clinical Psychologist in Elgin, IL
• Providers in Elgin, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.