Jep Healthcare Provider, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009807 Issued in IL

Legal business name

JEP HEALTHCARE PROVIDER, LLC

Practice address

1330 Kettering Rd
Mundelein, IL 60060-5364

Phone

(847) 287-9102

Fax

(847) 388-4711

NPI assigned

Oct 2, 2014

Last updated

Oct 2, 2014By 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

Joseph Escobar, APNNPI 1538419544

Title

President

Phone

(847) 287-9102

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Enrollment records 2

Practitioners 2

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.

• Joseph Escobar, ANP

  • Family Nurse Practitioner
  • Mundelein, IL
  • NPI 1538419544

  WI

  Medicare reassignment Care Compare group NPD Authorized official
• Ferdinand Catotal, FNP

  • Family Nurse Practitioner
  • Elgin, IL
  • NPI 1538681572

  Single Specialty, WI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1730582990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 KETTERING RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600605364",
            "telephone_number": "847-388-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 KETTERING RD",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600605364",
            "telephone_number": "847-287-9102",
            "fax_number": "847-388-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEP HEALTHCARE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "ESCOBAR",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-287-9102",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Irwin
• Damien Jackson
• Tanya Jacobson, LMT ABT
• Lisa Christine Javorkuti, LMT
• Hiba Jawadi
• Joann K. Nishimoto, PSYD, LLC
• Jonathan Beckerman DMD, P.C. Dba Excellent Dentistry
• Dashia D Jones
• Jori Riske LCSW, LTD.
• Josie G Oliva DDS PC

• Family Nurse Practitioner in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.