Active NPI
Simon Thomas Jencius, LCPC
- Professional Counselor
- Hoffman Estates, IL
National Provider Identifier
1972830669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-007342
- Practice address
- 1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029 - Phone
- (847) 755-8090
- Fax
- (847) 843-7393
- NPI assigned
- Nov 17, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-007342 | IL | Primary |
Addresses
Primary practice location
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Mailing address
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090
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 |
|---|---|---|---|
| 180-007342 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467763200000",
"number": "1972830669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1786 MOON LAKE BLVD",
"address_2": "SUITE 104",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601695029",
"telephone_number": "847-755-8090",
"fax_number": "847-843-7393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1786 MOON LAKE BLVD",
"address_2": "SUITE 104",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601695029",
"telephone_number": "847-755-8090",
"fax_number": "847-843-7393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENCIUS",
"first_name": "SIMON",
"middle_name": "THOMAS",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-17",
"last_updated": "2016-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-007342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoffman Estates, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.