Active NPI
Jessica Rose Trudeau, LSW
- Social Worker
- Aurora, IL
National Provider Identifier
1447732284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.104420
- Practice address
- 1230 N Highland Ave
Aurora, IL 60506-1401 - Phone
- (630) 966-4331
- NPI assigned
- Aug 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Social Worker | 104100000X | 150.104420 | IL | Primary |
Addresses
Primary practice location
1230 N Highland Ave
Aurora, IL 60506-1401
Mailing address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 766-3683
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.104420 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1447732284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HEALTH SERVICES DR",
"city": "DEKALB",
"state": "IL",
"postal_code": "601159637",
"telephone_number": "815-766-3683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 N HIGHLAND AVE",
"city": "AURORA",
"state": "IL",
"postal_code": "605061401",
"telephone_number": "630-966-4331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUDEAU",
"first_name": "JESSICA",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.104420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.