Individual provider Active NPI

Jerome Nerio None Missay Soku

  • Pastoral Counselor
  • Chicago, IL
National Provider Identifier
1689368789
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Practice address
126 E Chestnut St FL 3
Chicago, IL 60611-2014
Phone
(312) 787-8425
NPI assigned
Jun 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X Primary

Addresses

Primary practice location

126 E Chestnut St FL 3
Chicago, IL 60611-2014

Mailing address

1615 E 31St St
La Grange Park, IL 60526-1319
Phone (708) 800-7916

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Professional Associates LTD CurrentSince Jun 11, 2023 Accepting new patients

Locations

126 E Chestnut St
Fl 3
Chicago, IL 60611
Phone (312) 787-8425

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1689368789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 E 31ST ST",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261319",
            "telephone_number": "708-800-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E CHESTNUT ST FL 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112014",
            "telephone_number": "312-787-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSAY SOKU",
        "first_name": "JEROME NERIO",
        "middle_name": "NONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "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 Jun 5, 2023; 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.