Active NPI
Mark E Jasper, NP
- Nurse Practitioner
- Chicago, IL
National Provider Identifier
1508055112
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1499332
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1447 - Phone
- (773) 702-1000
- NPI assigned
- Oct 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1499332 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1447
Mailing address
728 W Jackson Blvd
Unit 610
Chicago, IL 60661-5490
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1499332 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1508055112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "728 W JACKSON BLVD",
"address_2": "UNIT 610",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606615490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASPER",
"first_name": "MARK",
"middle_name": "E",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-18",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "1499332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.