Individual provider Active NPI

Jordan Hupert, MD

  • Pediatric Clinical & Laboratory Immunology Physician
  • Chicago, IL
National Provider Identifier
1982614574
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Clinical & Laboratory Immunology PhysicianTaxonomy code 2080I0007X
License
036084510 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Aug 8, 2006
Last updated
Nov 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical & Laboratory Immunology Physician 2080I0007X 036084510 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

840 S Wood St
1245 CSB, MC 856
Chicago, IL 60612-4325
Phone (312) 413-3762

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090717000242 IL Practitioner - Pediatric Medicine 8325190630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036084510ILMDPediatric Clinical & Laboratory Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Apr 21, 2009 Accepting new patients
The Board of Trustees of the University of Illinois Clinical & Laboratory Immunology CurrentSince Apr 21, 2009 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

840 S Wood St
#1245
Chicago, IL 60612

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

Interoperability endpoints

  • Direct secure messaging: jhupert17126@uihealth.direct-ci.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1982614574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "1245 CSB, MC 856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-413-3762",
            "fax_number": "312-413-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPERT",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080I0007X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Clinical & Laboratory Immunology",
            "state": "IL",
            "license": "036084510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.