Individual provider Active NPI

Jean M Tucker, CNS, MS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Schaumburg, IL
National Provider Identifier
1740596543
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
209.008253 Issued in IL
Practice address
1375 E Schaumburg Rd
Suite 220
Schaumburg, IL 60194-5166
Phone
(847) 895-4540
Fax
(847) 895-4544
NPI assigned
Aug 31, 2010
Last updated
Sep 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 209.008253 IL Primary

Addresses

Primary practice location

1375 E Schaumburg Rd
Suite 220
Schaumburg, IL 60194-5166

Mailing address

1375 E Schaumburg Rd
Suite 220
Schaumburg, IL 60194-5166
Phone (847) 895-4540

Other identifiers 1

IdentifierTypeStateIssuer
209-008253OtherILLICENSE ADVANCE PRACTICE NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000371 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 5698960516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Healthcare Providers LTDGroup PAC ID 5395084297, 6 clinicians

Practice addresses (Care Compare)

1375 E Schaumburg Rd
Suite 230
Schaumburg, IL 60194-3658

1375 E Schaumburg Rd
Suite 240
Schaumburg, IL 60194-3643
Phone (847) 895-4540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science

State licenses

LicenseStateTypeSpecialty
209.008253ILMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Care Associates LTD PastSince Feb 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: behavioralhealthcareproviders.jeantucker@147503.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1740596543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E SCHAUMBURG RD",
            "address_2": "SUITE 220",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601945166",
            "telephone_number": "847-895-4540",
            "fax_number": "847-895-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E SCHAUMBURG RD",
            "address_2": "SUITE 220",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601945166",
            "telephone_number": "847-895-4540",
            "fax_number": "847-895-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "CNS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.008253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE ADVANCE PRACTICE NURSE",
            "identifier": "209-008253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.