Active NPI
Jessica M. Peelo Johnson
- Social Worker
- Elgin, IL
National Provider Identifier
1609129154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1845 Grandstand PL
Elgin, IL 60123-6603 - Phone
- (847) 695-0484
- NPI assigned
- Oct 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1845 Grandstand PL
Elgin, IL 60123-6603
Mailing address
1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1609129154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 GRANDSTAND PL",
"city": "ELGIN",
"state": "IL",
"postal_code": "601236603",
"telephone_number": "847-695-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 GRANDSTAND PL",
"city": "ELGIN",
"state": "IL",
"postal_code": "601236603",
"telephone_number": "847-695-0484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEELO JOHNSON",
"first_name": "JESSICA",
"middle_name": "M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.