Active NPI
Jason Sandberg
- Professional Counselor
- Schaumburg, IL
National Provider Identifier
1922791987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.014171
- Practice address
- 1623 Cottington Dr
Schaumburg, IL 60194-4525 - Phone
- (847) 651-9765
- NPI assigned
- May 26, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.014171 | IL | Primary |
Addresses
Primary practice location
1623 Cottington Dr
Schaumburg, IL 60194-4525
Mailing address
1623 Cottington Dr
Schaumburg, IL 60194-4525
Phone (847) 651-9765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.014171 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1922791987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 COTTINGTON DR",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601944525",
"telephone_number": "847-651-9765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1623 COTTINGTON DR",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601944525",
"telephone_number": "847-651-9765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDBERG",
"first_name": "JASON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-26",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.014171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.