Jessica Katz Edison, M.D.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

036140241 Issued in IL

Practice address

1555 Barrington Rd Lowr Level
Hoffman Estates, IL 60169-1019

Phone

(847) 490-4222

NPI assigned

Jun 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.edison.1@380.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  Medicare reassignment NPD

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1962841122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD LOWR LEVEL",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691019",
            "telephone_number": "847-490-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD LOWR LEVEL",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691019",
            "telephone_number": "847-490-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDISON",
        "first_name": "JESSICA",
        "middle_name": "KATZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IL",
            "license": "036140241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.edison.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1555 Barrington Rd Lowr Level",
            "city": "Hoffman Estates",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601691019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• E-Ztherapy,LLC
• Gregory Eakle, LPN
• Christopher Early
• Eastern Rise, LLC.
• Edge Medical Center LTD
• Emily Edlynn, PH.D.
• Kirsten M Edwards, LCSW
• Edwin P. Soriano, M.D., S.C.
• Kaitlyn Eichinger-Murphy, PSYD
• Eickert Physical Medicine LLC

• Developmental - Behavioral Pediatrics Physician in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Developmental - Behavioral Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.

Verify at the official NPI Registry.