Individual provider Active NPI

Jonathan George Perle, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Hoffman Estates, IL
National Provider Identifier
1881949295
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071.009471 Issued in IL
Practice address
2300 N. Barrington Rd
Suite 440
Hoffman Estates, IL 60169
Phone
(847) 469-7537
Fax
(847) 469-7540
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OOOO NE
Clinical Child & Adolescent Psychologist 103TC2200X 7201 OH
Clinical Child & Adolescent Psychologist 103TC2200X 071.009471 IL Primary

Addresses

Primary practice location

2300 N. Barrington Rd
Suite 440
Hoffman Estates, IL 60169

Mailing address

2300 N. Barrington Rd
Suite 440
Hoffman Estates, IL 60169
Phone (847) 469-7537

Other identifiers 1

IdentifierTypeStateIssuer
10025287200MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jperle268823@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622000530 WV Practitioner - Clinical Psychologist 8820315492 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OOOONEMDMental Health Counselor
071.009471ILMDClinical Child & Adolescent Psychologist
1281WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Education Building CurrentSince Jun 11, 2021 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jun 11, 2021 Accepting new patients
West Virginia University Medical Corporation Current Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

Interoperability endpoints

  • Direct secure messaging: jperle268823@direct.wvuhsdirect.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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1881949295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N. BARRINGTON RD",
            "address_2": "SUITE 440",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-469-7537",
            "fax_number": "847-469-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N. BARRINGTON RD",
            "address_2": "SUITE 440",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-469-7537",
            "fax_number": "847-469-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLE",
        "first_name": "JONATHAN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "OOOO",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "7201",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071.009471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025287200",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jperle268823@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "930 Chestnut Ridge Rd",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265052807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.