MR. JESSE DEWAYNE HERRON (NPI# 1841706371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841706371 |
| Entity Type | Individual |
| Full Name | MR. JESSE DEWAYNE HERRON |
| Credential | APRN, CRNP, PMHNP-BC |
| Practice Address |
912 S Wood St # Mc913 Chicago IL 60612-4300 |
| Mailing Address |
912 S Wood St Chicago IL 60612-4300 |
| Practice Telephone | 3129962200 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2018-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
1-144296 | AL | Nursing Service Providers |
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
041460500 | IL | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
209.017099 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
912 S WOOD ST # MC913 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437578044 | Jason Ryan Soble | Clinical Neuropsychologist | 912 S Wood St # Mc913, Chicago, IL 60612-4300 | 2014-04-10 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549755 | Maria Andreea Bordeianu | Nurse Practitioner | 6050 N California Ave, Chicago, IL 60659-3916 | 2020-05-16 |
| 1114574886 | Hyde Park Mental Wellness | Nurse Practitioner | 1525 E 55th St Ste 205, Chicago, IL 60615-5584 | 2019-08-19 |
| 1689232522 | Sarah Ball Schrock | Nurse Practitioner | 3310 W Division St, Chicago, IL 60651-2301 | 2019-06-05 |
| 1982168407 | Richardson Psychiatric | Nurse Practitioner | 3660 N Lake Shore Dr Ste 201, Chicago, IL 60613-5302 | 2019-01-29 |
| 1386117232 | Prudent Alliance for Healthcare, LLC | Nurse Practitioner | 6159 W Eddy St, Chicago, IL 60634-4122 | 2019-01-03 |
| 1770068421 | Gian Bonador | Nurse Practitioner | 1134 W Granville Ave Apt 715, Chicago, IL 60660-5047 | 2018-09-28 |
| 1790115293 | Stacey Marie Meyers | Nurse Practitioner | 6439 N Sheridan Rd Ste 310, Chicago, IL 60626-5364 | 2013-11-19 |
| 1326385824 | Deborah Francine Bump | Nurse Practitioner | 6918 S Euclid Ave, Chicago, IL 60649-1512 | 2013-01-03 |
| 1104058221 | Lester Eugene Lamee Jr. | Nurse Practitioner | 251 E Huron Street, Northwestern Memorial Hospital, Chicago, IL 60611 | 2009-08-24 |
| 1720003577 | Janice E Stern | Nurse Practitioner | 1645 W Jackson Blvd Ste 602, Chicago, IL 60612 | 2006-07-13 |
| Find all providers in CHICAGO | ||||
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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.