Jaclyn Ross PHD PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

JACLYN ROSS PHD PLLC

Practice address

53 W Jackson Blvd Ste 336
Chicago, IL 60604-3688

Phone

(708) 665-4721

NPI assigned

Jan 16, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jaclyn Ross, PHDNPI 1538832464

Title

Clinical Psychologist

Phone

(312) 210-0374

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Ross, PHD

  • Psychologist
  • Chicago, IL
  • NPI 1538832464
  NPD Authorized official

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1881455012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W SAINT PAUL AVE APT 133",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475343",
            "telephone_number": "908-246-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD STE 336",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043688",
            "telephone_number": "708-665-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN ROSS PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-210-0374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyra M Jackson, PHD
• William Jackson III
• Yolanda Willine Jackson
• Zarrianna Nevada Jackson
• Zoe Jackson, RN
• Ancy Chakkalakal Jacob, FNP-C
• Carolyn Jacob, MD
• James Jacob, DPT
• Jino Jacob, OT
• Kevin Chacko Jacob, MD

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.