Individual provider Active NPI

Marian Jurewicz

  • Addiction (Substance Use Disorder) Counselor
  • Chicago, IL
National Provider Identifier
1912739533
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
24195 Issued in IL
Practice address
2020 W Harrison St
Chicago, IL 60612-3741
Phone
(312) 572-4818
NPI assigned
Aug 14, 2024
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 24195 IL Primary

Addresses

Primary practice location

2020 W Harrison St
Chicago, IL 60612-3741

Mailing address

1728 W Farwell Ave Apt 305
Chicago, IL 60626-3237
Phone (773) 391-7418

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

LicenseStateTypeSpecialty
24195ILMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1912739533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W FARWELL AVE APT 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263237",
            "telephone_number": "773-391-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123741",
            "telephone_number": "312-572-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUREWICZ",
        "first_name": "MARIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "24195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.