Active NPI
Jonathan Uebelhor
- Adult Health Nurse Practitioner
- Chicago, IL
National Provider Identifier
1558679654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 209007567
- Practice address
- 680 N Lake Shore Dr
Chicago, IL 60611 - Phone
- (312) 695-6868
- NPI assigned
- Sep 23, 2010
- Last updated
- May 21, 2018
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209007567 | IL | Primary |
Addresses
Primary practice location
680 N Lake Shore Dr
Chicago, IL 60611
Mailing address
680 N Lake Shore Dr
Chicago, IL 60611-4546
Phone (312) 695-6868
Other practice location 1
1653 W. Congress Parkway
Rush University Medical Center
Chicago, IL 60612
Phone (312) 942-5000
Other practice location 2
259 E Erie St
Chicago, IL 60611-2987
Phone (312) 695-6868
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hematology Oncology Associates of Illinois LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hematology & Oncology Physician
- Chicago, IL
- NPI 1538120381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1558679654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 N LAKE SHORE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114546",
"telephone_number": "312-695-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 N LAKE SHORE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-695-6868"
}
],
"practiceLocations": [
{
"address_1": "1653 W. Congress Parkway",
"address_2": "Rush University Medical Center",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60612",
"country_code": "US",
"telephone_number": "312-942-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "259 E Erie St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112987",
"country_code": "US",
"telephone_number": "312-695-6868",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UEBELHOR",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-23",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209007567",
"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 May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.