JACOB CONDITT (NPI# 1609490531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609490531 |
| Entity Type | Individual |
| Full Name | JACOB CONDITT |
| Credential | OD |
| Practice Address |
820 S Damen Ave Chicago IL 60612-3728 |
| Mailing Address |
2712 Mcdougald St Newport AR 72112-3014 |
| Practice Telephone | 3125698387 |
| Mailing Telephone | 8706646632 |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2020-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 11785522-9934 | UT | Student, Health Care |
| Street Address |
820 S DAMEN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679561260 | Jesse Brown Veterans Administration Hospital | General Acute Care Hospital | 820 S Damen Ave, Chicago, IL 60612-3728 | 2005-10-09 |
| 1528678463 | Jennifer Lee | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-08-05 |
| 1770101115 | Natalia Irena Szynalik | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-07-13 |
| 1568088706 | Benjamin Galloway | Podiatrist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-23 |
| 1588280937 | Laine Ferrill | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-22 |
| 1598380560 | Regan Kelley | Speech-Language Pathologist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-15 |
| 1023632551 | Stephen Macrowski | Dentist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-01 |
| 1588286256 | Nisha Utpal Patel | Dentist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-05-15 |
| 1568084804 | Tuhin Mukherjee | Podiatrist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-05-09 |
| 1740818848 | Jared Benjamin Siegel | Student in an Organized Health Care Education/Training Program | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1275146599 | Ryan Mather | Student in an Organized Health Care Education/Training Program | 155 N Michigan Ave Ste 566, Chicago, IL 60601-7799 | 2020-08-26 |
| 1831701010 | Alexandra Klonis | Student in an Organized Health Care Education/Training Program | 676 N Saint Clair St Ste 6-108, Chicago, IL 60611-2927 | 2020-08-19 |
| 1851903389 | Brittney Christine Evans | Student in an Organized Health Care Education/Training Program | 1901 N Clybourn Ave Ste 302&304, Chicago, IL 60614-5090 | 2020-08-17 |
| 1205446358 | Kai Lai Chu | Student in an Organized Health Care Education/Training Program | 600 N Fairbanks Ct Unit 3505, Chicago, IL 60611-5869 | 2020-08-04 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1407474463 | Madison Nicole Schulenberg | Student in an Organized Health Care Education/Training Program | 1111 W 14th Pl Unit 119, Chicago, IL 60608-2796 | 2020-07-07 |
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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.