Active NPI
Jordan Lynn, ATC
- Athletic Trainer
- River Forest, IL
National Provider Identifier
1932865839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.004991
- Practice address
- 7400 Augusta St
River Forest, IL 60305-1402 - Phone
- (708) 209-3620
- NPI assigned
- Nov 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.004991 | IL | Primary |
Addresses
Primary practice location
7400 Augusta St
River Forest, IL 60305-1402
Mailing address
1630 W Woods Dr Apt 1411
Arlington Heights, IL 60004-8019
Phone (217) 891-4372
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | jordan.lynn@cuchicago.edu |
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 |
|---|---|---|---|
| 096.004991 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1932865839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1630 W WOODS DR APT 1411",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600048019",
"telephone_number": "217-891-4372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 AUGUSTA ST",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051402",
"telephone_number": "708-209-3620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNN",
"first_name": "JORDAN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.004991",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "jordan.lynn@cuchicago.edu",
"affiliation": "N",
"address_1": "7400 Augusta St",
"city": "River Forest",
"state": "IL",
"country_code": "US",
"postal_code": "603051402",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in River Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.