Individual provider Active NPI

Jane Y.C. Mann, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1912085580
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007172 Issued in IL
Practice address
2600 S Michigan Ave Ste 408
Chicago, IL 60616-2696
Phone
(312) 808-0900
Fax
(630) 653-1025
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-006496 IL
Clinical Psychologist 103TC0700X 071007172 IL Primary

Addresses

Primary practice location

2600 S Michigan Ave Ste 408
Chicago, IL 60616-2696

Mailing address

2600 S Michigan Ave Ste 408
Chicago, IL 60616-2696
Phone (312) 808-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080718000613 IL Practitioner - Clinical Psychologist 3173596756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2216 S Wentworth Ave
Chicago, IL 60616-2012
Phone (312) 328-1188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-006496ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shirley S Wong M.D.S.C. CurrentSince Mar 7, 2023 Accepting new patients
Pui Tak Center CurrentSince Apr 14, 2026 Accepting new patients
Meier Clinics of Illinois, P.C. Clinical Past Accepting new patients
Meier Clinics of Illinois, P.C. Past Accepting new patients

Locations

2600 S Michigan Ave
Ste 408
Chicago, IL 60616
Phone (312) 808-0900

2216 S Wentworth Ave
Chicago, IL 60616
Phone (312) 328-1188

2335 S Wentworth Ave
Ste B
Chicago, IL 60616
Phone (312) 566-4545

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1912085580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE STE 408",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162696",
            "telephone_number": "312-808-0900",
            "fax_number": "630-653-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S MICHIGAN AVE STE 408",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162696",
            "telephone_number": "312-808-0900",
            "fax_number": "630-653-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JANE",
        "middle_name": "Y.C.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-006496",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.