Active NPI
Jeremy David Cornish, LAC.
- Acupuncturist
- Downers Grove, IL
National Provider Identifier
1902136294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 198000842
- Practice address
- 5844 Walnut Ave
Apt 2C
Downers Grove, IL 60516-6022 - Phone
- (315) 368-7457
- NPI assigned
- Jan 8, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 198000842 | IL | Primary |
Addresses
Primary practice location
5844 Walnut Ave
Apt 2C
Downers Grove, IL 60516-6022
Mailing address
5844 Walnut Ave
Apt 2C
Downers Grove, IL 60516-6022
Phone (315) 368-7457
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198000842 | IL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1902136294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5844 WALNUT AVE",
"address_2": "APT 2C",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605166022",
"telephone_number": "315-368-7457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5844 WALNUT AVE",
"address_2": "APT 2C",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605166022",
"telephone_number": "315-368-7457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNISH",
"first_name": "JEREMY",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LAC.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-08",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": "198000842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.