Jason Cory Tjaden, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-109-900 Issued in IL

Practice address

301 N Randall Rd
Lake in the Hills, IL 60156-5961

Phone

(847) 658-6065

Fax

(847) 658-6136

NPI assigned

Apr 18, 2006

Last updated

Jul 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children's Medical Group, S.C.

  • Pediatrics Physician
  • Lake in the Hills, IL
  • NPI 1740483718
  NPD Authorized official

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1447215033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N RANDALL RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565961",
            "telephone_number": "847-658-6065",
            "fax_number": "847-658-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N RANDALL RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565961",
            "telephone_number": "847-658-6065",
            "fax_number": "847-658-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJADEN",
        "first_name": "JASON",
        "middle_name": "CORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036109900",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-109-900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Toman, MPT
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• Scott W Torpe
• Heidi Torres

• Pediatrics Physician in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.