Individual provider Active NPI

Jennifer Laflamme, DO

  • Psychiatry Physician
  • Park Ridge, IL
National Provider Identifier
1811576416
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.078949 Issued in IL
Practice address
1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129
Phone
(847) 795-5865
Fax
(847) 723-5882
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125.078949 IL Primary

Addresses

Primary practice location

1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129

Mailing address

1875 W Dempster St Ste 470
Park Ridge, IL 60068-1129
Phone (847) 795-5865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231205001264 IL Practitioner - Psychiatry 4880042662 Reassigns benefits to 1 organization
I20260113000391 WI Practitioner - Psychiatry 4880042662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1860 W Winchester Rd
Suite 106
Libertyville, IL 60048-5312
Phone (847) 816-6335

4600 Green Bay Rd
Kenosha, WI 53144-1719
Phone (847) 816-6335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.078949ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC Psychiatry CurrentSince Nov 1, 2023 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Psychiatry CurrentSince Nov 1, 2023 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Psychiatry Past Accepting new patients

Locations

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Interoperability endpoints

  • Direct secure messaging: jennifer.laflamme.1@9664.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1811576416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865",
            "fax_number": "847-723-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-795-5865",
            "fax_number": "847-723-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFLAMME",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.078949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.