Individual provider Active NPI

Jordan Leonidas Hunter, MD, MS

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1912683129
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.082927 Issued in IL
Practice address
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone
(312) 942-5495
NPI assigned
Jun 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125.082927 IL Primary

Addresses

Primary practice location

600 S Paulina St Ste 403
Chicago, IL 60612-3806

Mailing address

2150 W Harrison St
Chicago, IL 60612-3706

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017002108 IL Order and Referring Only - PsychiatryPractitioner - Psychiatry 6305291964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
125.082927ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1912683129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "JORDAN",
        "middle_name": "LEONIDAS",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.082927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.