Individual provider Active NPI

Nelly P Jimenez

  • Professional Counselor
  • Northfield, IL
National Provider Identifier
1730603168
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
405 Central Avenue
Northfield, IL 60093
Phone
(847) 441-5603
Fax
(847) 441-7968
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

405 Central Avenue
Northfield, IL 60093

Mailing address

2471 Girard Turn
Kankakee, IL 60901-7360
Phone (630) 605-7949

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1730603168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 GIRARD TURN",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609017360",
            "telephone_number": "630-605-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CENTRAL AVENUE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "60093",
            "telephone_number": "847-441-5603",
            "fax_number": "847-441-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "NELLY",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.