Active NPI
Palmer Jones McCluskey
- Counselor
- Waukegan, IL
National Provider Identifier
1942763354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 671 S Lewis Ave
Waukegan, IL 60085-6101 - Phone
- (847) 782-4000
- NPI assigned
- Apr 11, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
671 S Lewis Ave
Waukegan, IL 60085-6101
Mailing address
1910 Hilton Ave
Columbus, GA 31906-1543
Phone (706) 580-5623
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556409600000",
"number": "1942763354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 HILTON AVE",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319061543",
"telephone_number": "706-580-5623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "671 S LEWIS AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600856101",
"telephone_number": "847-782-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLUSKEY",
"first_name": "PALMER",
"middle_name": "JONES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-11",
"last_updated": "2019-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.