Robert Carl Jespersen, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036070086 Issued in IL

Practice address

625 Slawin CT
Mount Prospect, IL 60056-2183

Phone

(847) 789-7155

Fax

(847) 789-7161

NPI assigned

Oct 23, 2006

Last updated

Feb 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenview Health Center Chartered

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1184632051

  General Practice

  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1407939630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 N SHERIDAN RD",
            "address_2": "#28-S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604771",
            "telephone_number": "773-989-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SLAWIN CT",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562183",
            "telephone_number": "847-789-7155",
            "fax_number": "847-789-7161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 N Sheridan Rd",
            "address_2": "#28-s",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606604771",
            "country_code": "US",
            "telephone_number": "773-784-7852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESPERSEN",
        "first_name": "ROBERT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036070086",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036070086",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001627310",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "F300267780",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070086",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vidhi Jain
• James J. Nuzzo DPM SC
• Janusz Mejer MD, SC.
• Jeffrey W. Collins, P.C. (Collins Chiropractic Center)
• Fred Jendo, C.S.A.
• Tessel Jicku
• Sogol Jahedi Jimenez, MD
• JM Supplies Inc
• JM Supplies Inc
• John D Lane, DDS, LTD

• Psychiatry Physician in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.