Jacques Gourguechon, LPC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

178.010830 Issued in IL

Legal business name

JACQUES GOURGUECHON, LPC

Practice address

1454 W Farragut Ave
Chicago, IL 60640-2104

Phone

(312) 203-9211

NPI assigned

May 15, 2015

Last updated

May 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacques A. Gourguechon, LPCNPI 1972990190

Title

Principal

Phone

(312) 203-9211

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacques A. Gourguechon, LPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1972990190
  Authorized official Same address or phone

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1730567207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 W FARRAGUT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402104",
            "telephone_number": "312-203-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 W FARRAGUT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402104",
            "telephone_number": "312-203-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUES GOURGUECHON, LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "GOURGUECHON",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "312-203-9211",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "178.010830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freddy Jacome
• Oscar Jacome, DPT
• Francky Jacque, MD
• Jacqueline Herbstman, LCSW, P.C.
• Jacqueline Rodriguez, DMD, P.C.
• Kristianna E Jacques, LCSW
• Rachele' Jacques, PHLEBOTOMIST AND MED
• Imani Jacquet
• Gabriela Jacquez-Jimenez, COTA/L
• Ofelia Jaczko

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.