Individual provider Active NPI

Jenny Abraham, APN

  • Child & Adolescent Psychiatry Physician
  • Downers Grove, IL
National Provider Identifier
1396322392
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
209020751 Issued in IL
Practice address
5207 Main St
Downers Grove, IL 60515-4652
Phone
(815) 314-5282
NPI assigned
Mar 25, 2021
Last updated
May 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 209020751 IL
Child & Adolescent Psychiatry Physician 2084P0804X 209020751 IL Primary

Addresses

Primary practice location

5207 Main St
Downers Grove, IL 60515-4652

Mailing address

PO Box 713260
Chicago, IL 60677-0018
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jabraham229124@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209020751ILMDChild & Adolescent Psychiatry Physician

Interoperability endpoints

  • Direct secure messaging: jabraham229124@dulyhealthandcare.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1396322392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154652",
            "telephone_number": "815-314-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JENNY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "209020751",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "209020751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jabraham229124@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5207 Main St",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605154652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.