Active NPI
Jessica Jean Hazel, D.C.
- Chiropractor
- Chicago, IL
National Provider Identifier
1992000913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.011867
- Practice address
- 4300 N Clark St
Chicago, IL 60613-1302 - Phone
- (517) 648-1841
- NPI assigned
- Jan 22, 2011
- Last updated
- Jan 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.011867 | IL | Primary |
Addresses
Primary practice location
4300 N Clark St
Chicago, IL 60613-1302
Mailing address
4300 N Clark St
Chicago, IL 60613-1302
Phone (517) 648-1841
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.011867 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Lotus Chiropractic of Oak Park LTD | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Oak Park, IL
- NPI 1699066167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1992000913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131302",
"telephone_number": "517-648-1841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131302",
"telephone_number": "517-648-1841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEL",
"first_name": "JESSICA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-22",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.011867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.