Individual provider Active NPI

Jamie Sandberg

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1851177216
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6639 N Kedzie Ave
Chicago, IL 60645-4161
Phone
(312) 804-3766
NPI assigned
Sep 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6639 N Kedzie Ave
Chicago, IL 60645-4161

Mailing address

6639 N Kedzie Ave
Chicago, IL 60645-4161

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Child and Family Services CurrentSince Nov 1, 2024 Accepting new patients
Jewish Child and Family Services PastSince Sep 5, 2023 Accepting new patients

Locations

6639 N Kedzie Ave
Chicago, IL 60645
Phone (773) 765-3100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1851177216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6639 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6639 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454161",
            "telephone_number": "312-804-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBERG",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.