Jacob Penrod

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166001698 Issued in IL

Practice address

1300 W Belmont Ave Ste 300
Chicago, IL 60657-3200

Phone

(773) 880-1310

NPI assigned

Jun 25, 2021

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

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 and National Provider Directory roles.

• Live Oak, Inc.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1629141163
  NPD

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1487224135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "773-880-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Wilson Pennisi, PT
• Penny McGrath LCPC LLC
• Stephanie Elizabeth Penny, DPT
• Scotia Baker Penoyer, LCSW
• Alexander Joseph Penrice, MD
• Cyndie Penrose
• Anthony V Pensa, MD
• Alicia Celeste Pensamiento
• Jay Michael Pensler, M.D.
• Debra Suzann Pentangelo, LCSW

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.