Organization Active NPI

Cynthia E. Jaffe

  • Family Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1497942015
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009692 Issued in IL
Legal business name
CYNTHIA E. JAFFE
Practice address
3100 Dundee Rd Ste 506
Northbrook, IL 60062-2449
Phone
(847) 830-8748
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Cynthia Jaffe
Title
Owner
Phone
(847) 830-8748

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X 038008595 IL
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 209009692 IL Primary

Addresses

Primary practice location

3100 Dundee Rd Ste 506
Northbrook, IL 60062-2449

Mailing address

1215 Daryl LN
Northbrook, IL 60062-4610
Phone (847) 830-8748

Other identifiers 1

IdentifierTypeStateIssuer
1699854778OtherILNPI

National Provider Directory

National Provider Directory

Locations

11 E Adams St
Ste 708
Chicago, IL 60603
Phone (302) 939-5960

1434 Shermer Rd
Northbrook, IL 60062
Phone (312) 939-5960

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1497942015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 DARYL LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624610",
            "telephone_number": "847-830-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 DUNDEE RD STE 506",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622449",
            "telephone_number": "847-830-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA E. JAFFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-830-8748"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "IL",
            "license": "038008595",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699854778",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.