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  7. NPI Record 1295247112

JANICE NICHOLSON
Complete NPI Record 1295247112
Psychologist - School in Chicago, IL

NPI Status: Active since November 01, 2017

Contact Information

2651 W WASHINGTON BLVD
CHICAGO, IL
ZIP 60612
Phone: (773) 553-1800

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Enumeration Date
  17. Last Update Date
  18. Provider Gender Code
  19. Healthcare Provider Taxonomy Code 1
  20. Provider License Number 1
  21. Provider License Number State Code 1
  22. Healthcare Provider Primary Taxonomy Switch 1
  23. Other Provider Identifier 1
  24. Other Provider Identifier Type Code 1
  25. Other Provider Identifier State 1
  26. Other Provider Identifier Issuer 1
  27. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1295247112. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1295247112
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Entity Type Code: 1
The name of the organization provider. If the provider is an organization, this is the legal business name.
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider First Name: JANICE
The city name in the mailing address of the provider being identified.
Provider First Line Business Mailing Address: 2651 W WASHINGTON BLVD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address City Name: CHICAGO
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 606122055
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 2651 W WASHINGTON BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CHICAGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: IL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 606122055
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7735531800
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/1/2017
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/1/2017
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 103TS0200X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 1876161
The 10-position telephone number of the authorized official.
Provider License Number State Code 1: IL
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Other Provider Identifier 1: 1876161
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Other Provider Identifier Type Code 1: 01
Other Provider Identifier State 1: IL
Other Provider Identifier Issuer 1: ILLINOIS STATE BOARD OF EDUCATION
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No