Jacqueline Rochelle Ross, PHD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178008975 Issued in IL

Practice address

1139 Leavitt Ave
Unit 210
Flossmoor, IL 60422-1550

Phone

(708) 957-9420

Fax

(708) 365-6392

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Steppin Stone Womens Resources Center

  • Community/Behavioral Health Agency
  • Flossmoor, IL
  • NPI 1568890689
  NPD (past) Authorized official

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1770916165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 LINCOLN HWY",
            "address_2": "SUITE 6",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611627",
            "telephone_number": "708-957-9420",
            "fax_number": "708-365-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 LEAVITT AVE",
            "address_2": "UNIT 210",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221550",
            "telephone_number": "708-957-9420",
            "fax_number": "708-365-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACQUELINE",
        "middle_name": "ROCHELLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178008975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Roome, M.D.
• Root & Resonance PLLC
• Davida Rosenbloom, LCSW
• Nathan S Rosendale, PT, DPT
• Gracemary Rosenthal, LCSW
• Jeffrey Rudloff, DPT
• Kimbery Christine Rush, M.S. CCC/SLP
• Shanyta Russell
• Eric Ryles
• S.I.S & Associates, LLC

• Professional Counselor in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.