Jamie Kelly, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180009599 Issued in IL

Practice address

1010 Jorie Blvd Ste 200
Oak Brook, IL 60523-2240

Phone

(773) 321-2734

NPI assigned

Nov 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springsource Psychological Center PLLCGroup PAC ID 6901381490, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Springsource Psychological Center PLLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1033735550
  Medicare reassignment Care Compare group
• Insight Behavioral Health Centers

  • Group Psychotherapy Psychologist
  • Oak Brook, IL
  • NPI 1114387602
  NPD (past)

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

{
    "created_epoch": "1448582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1477927697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 JORIE BLVD STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 JORIE BLVD STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232240",
            "telephone_number": "773-321-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-27",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180009599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Kaufman, PT, ATC
• Natasha Kaur, MD
• Thomas Earl Keane, MD
• Briana M Keating
• Allison Keel
• Curtis Kempel, DC
• Edward J Kenter, MS, ATC
• Jennifer Kepler
• Khadija Khan MDSC
• Imran Khan, PHARM.D

• Counselor in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.