Jordan Boerema, LCPC, ATR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180011342 Issued in IL

Practice address

2500 W Bradley PL Ste 100
Chicago, IL 60618-4716

Phone

(773) 649-0787

NPI assigned

May 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1962993857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 N KEDZIE AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182471",
            "telephone_number": "847-721-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BRADLEY PL STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184716",
            "telephone_number": "773-649-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEREMA",
        "first_name": "JORDAN",
        "credential": "LCPC, ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Ang Boege, DMD
• Larry M Boehlke, NP
• Devin Joseph Boehm
• John Jason Boehm, MS, CNS, MMC
• Chloe Marie Boensch, LCSW
• Celine Boers, NP
• Tamara Boers, MD
• Kari Michelle Boersen, PA-C
• Meghan Kathleen Boesen, APN, CNP
• Amy M Boettcher, CRNA

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.