DR. JASON JOHN JERISHA (NPI# 1467402388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467402388 |
| Entity Type | Individual |
| Full Name | DR. JASON JOHN JERISHA |
| Credential | DPM |
| Practice Address |
775 Waukegan Rd Suite 200 Deerfield IL 60015-4342 |
| Mailing Address |
232 Arbors Pkwy W Number 22 Findlay OH 45840-8741 |
| Practice Telephone | 8003170711 |
| Practice Fax Number | 8004347113 |
| Mailing Telephone | 4194251901 |
| Mailing Fax Number | 4194272688 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 36-003416 | OH | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2589819 | 05 | |
| OH | ANTHEM BCBS | 000000377305 | 01 |
| OH | ANTHEM BCBS | 000000543939 | 01 |
| Street Address |
775 WAUKEGAN RD SUITE 200 |
| City | DEERFIELD |
| State | IL |
| Zip Code | 60015-4342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245215318 | Daryl Kinshasa Jenkins | Podiatrist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2005-12-13 |
| 1881992469 | Vesna Simic, Inc. | Optometrist | 775 Waukegan Rd, Suite 170, Deerfield, IL 60015-4342 | 2011-03-07 |
| 1386977254 | Tiffany Dawn Vasiloff | Audiologist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2009-09-10 |
| 1558509653 | Matthew W Lackney | Dentist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2009-01-27 |
| 1255589222 | Ej Vision, Inc. | Technician/Technologist | 775 Waukegan Rd, Suite 170, Deerfield, IL 60015-4342 | 2008-09-03 |
| 1912041468 | Vesna Simic | Optometrist | 775 Waukegan Rd, Suite 170, Deerfield, IL 60015-4342 | 2007-02-17 |
| 1134268758 | Ann E. Clifton | Audiologist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2007-02-06 |
| 1942359153 | Kathleen S. Liston | Audiologist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2007-01-09 |
| 1316975576 | Eric Beatty | Podiatrist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2006-06-28 |
| 1013967181 | Michael Wayne Hammer | Optometrist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073569 | Steven A Ditgen | Physical Therapist | 43 N. Waukegan Road, Deerfield, IL 60015 | 2020-04-29 |
| 1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
| 1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1528628484 | Cynthia Lynne Mckinzie | Psychologist | The Neuroscience Center, 440 Lake Cook Road, Deerfield, IL 60015 | 2019-06-13 |
| 1073084497 | Mary Jeane Jeane Velez | Nurse Practitioner | Brentwood Rehabilitation Center, 3705 Deerfield Rd., Deerfield, IL 60015 | 2018-12-11 |
| 1891264644 | Smile On of North Shore, PC | Dentist | 707 Lake Cook Rd., Suite 121, Deerfield, IL 60015 | 2018-11-21 |
| 1497236376 | Linda Li | Counselor | 15 Parkway North Blvd, Deerfield, IL 60015 | 2018-08-28 |
| 1174009831 | Rachael Michelle Lynn | Physician Assistant | 1302 Hazel Ave, Deerfield, IL 60015 | 2018-07-16 |
| 1730675182 | Alexandra Lee Joseph | Social Worker | 420 Lake Cook Road, Suite 113, Deerfield, IL 60015 | 2018-07-09 |
| Find all providers in zip 60015 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285801514 | Karlyn Rosenstiel | Podiatrist | 1014 Central Ave, Deerfield, IL 60015-4215 | 2008-05-15 |
| 1245215318 | Daryl Kinshasa Jenkins | Podiatrist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2005-12-13 |
| 1972913085 | Dr. Morrie Katz | Podiatrist | 420 Lake Cook Rd, 116, Deerfield, IL 60015-5646 | 2014-04-29 |
| 1992115182 | Dr. Morrie Katz | Podiatrist | 420 Lake Cook Rd, 116, Deerfield, IL 60015-5646 | 2014-04-28 |
| 1174629265 | North Suburban Foot & Ankle Centers | Podiatrist | 400 Lake Cook Rd, Suite 101, Deerfield, IL 60015-5607 | 2006-09-15 |
| 1316975576 | Eric Beatty | Podiatrist | 775 Waukegan Rd, Suite 200, Deerfield, IL 60015-4342 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1306452099 | Podiatric Management Systems LLC | Podiatrist | 2 W Talcott Rd Ste 23, Park Ridge, IL 60068-5558 | 2020-09-18 |
| 1073129763 | Podiatric Management Systems LLC | Podiatrist | 4310f W Crystal Lake Rd # F, Mchenry, IL 60050-4208 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1689145898 | S Thomas Sehy D P M L L C | Podiatrist | 213 Nw 10th St Ste B, Fairfield, IL 62837-1219 | 2018-12-16 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1932693744 | Giovanni Incandela | Podiatrist | 700 E Algonquin Rd Unit 2313, Schaumburg, IL 60173-3835 | 2018-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.