Active NPI
Jennifer Macdonald, MD
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1942695507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036153214
- Practice address
- 835 N Rockwell St Apt 1
Chicago, IL 60622-4553 - Phone
- (773) 954-9697
- NPI assigned
- Mar 31, 2015
- Last updated
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Family Medicine Physician | 207Q00000X | 036153214 | IL | Primary |
Addresses
Primary practice location
835 N Rockwell St Apt 1
Chicago, IL 60622-4553
Mailing address
835 N Rockwell St Apt 1
Chicago, IL 60622-4553
Phone (773) 954-9697
Other practice location 1
100 Cheyenne Ave
Lame Dear, MT 59043
Phone (406) 477-4400
Other practice location 2
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036153214 | IL | MD | Family Medicine Physician |
Interoperability endpoints
- jennifer.macdonald.1@13158.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1942695507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 N ROCKWELL ST APT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606224553",
"telephone_number": "773-954-9697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 N ROCKWELL ST APT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606224553",
"telephone_number": "773-954-9697"
}
],
"practiceLocations": [
{
"address_1": "100 Cheyenne Ave",
"address_purpose": "LOCATION",
"city": "Lame Dear",
"state": "MT",
"postal_code": "59043",
"country_code": "US",
"telephone_number": "406-477-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3181 SW Sam Jackson Park Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393011",
"country_code": "US",
"telephone_number": "503-494-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACDONALD",
"first_name": "JENNIFER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2020-11-16",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036153214",
"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 Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.