Active NPI
Jason Yu
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1508289331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.003645
- Practice address
- 1915 S Archer Ave
Chicago, IL 60616-1618 - Phone
- (312) 674-9132
- NPI assigned
- Jan 30, 2014
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.003645 | IL | Primary |
Addresses
Primary practice location
1915 S Archer Ave
Chicago, IL 60616-1618
Mailing address
768 W 26TH St
Chicago, IL 60616-1808
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 |
|---|---|---|---|
| 096.003645 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1508289331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "768 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 S ARCHER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606161618",
"telephone_number": "312-674-9132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU",
"first_name": "JASON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.003645",
"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 Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.