JACK FORREST HOUSTON (NPI# 1881819589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881819589 |
| Entity Type | Individual |
| Full Name | JACK FORREST HOUSTON |
| Practice Address |
5th Avenue & Roosevelt Road Building 113 Hines IL 60141 |
| Mailing Address |
1612 Robert Ln Naperville IL 60564-7126 |
| Practice Telephone | 7082023628 |
| Mailing Telephone | 6309042478 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255R0406X |
Specialist/Technologist Specialization: Rehabilitation, Blind |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5TH AVENUE & ROOSEVELT ROAD BUILDING 113 |
| City | HINES |
| State | IL |
| Zip Code | 60141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992273056 | Donizetti Razo | Social Worker | 5000 S. Fifth Avenue, Building 228, Room 4078, Hines, IL 60141 | 2018-11-07 |
| 1558838086 | Michael Calia | Social Worker | Patient Advocate Office #122, Edward Hines Jr. Va Hospital, 5000 S. 5th Avenue, Hines, IL 60141 | 2018-11-02 |
| 1639684640 | David Alan Edwards | Specialist/Technologist | 5000 S 5ht Ave, Building 113, Hines, IL 60141 | 2017-12-13 |
| 1689189706 | Joseph Jorgenson | Rehabilitation Practitioner | Hines Brc Bld 113, 5000 S 5th Ave, 124, Hines, IL 60141 | 2017-12-12 |
| 1154836823 | Kristy Bassett | Social Worker | 5000 S 5th Ave Bldg 2284n, Hines, IL 60141 | 2017-12-04 |
| 1396269387 | Aaron Jerome Brown | Kinesiotherapist | 5000 S 5th. Ave., Hines, IL 60141 | 2017-08-01 |
| 1932454634 | Michael Ladra Marquez | Physical Therapist | 5000 South 5th Ave., Edward Hines Jr. Va Hospital, Hines, IL 60141 | 2012-07-18 |
| 1437489713 | Linda Christime Bronski | Social Worker | Fifth Ave and Roosevelt Ave Bldg 228, Edward Hines Jr Va Hospital, Hines, IL 60141 | 2010-01-08 |
| 1700113859 | Sarah Jean Ostrowski | Recreation Therapist | 2100 S 5th Ave, Hines, IL 60141 | 2009-11-11 |
| 1841447299 | Narayanarao Madamala | Pharmacist | Hines Consolidated Mail Out Pharmacy, Building 37nw, Hines, IL 60141 | 2008-08-27 |
| Find all providers in zip 60141 | ||||
| Taxonomy Code | 2255R0406X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Rehabilitation, Blind |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639684640 | David Alan Edwards | Specialist/Technologist | 5000 S 5ht Ave, Building 113, Hines, IL 60141 | 2017-12-13 |
| 1356467948 | Geo Athappilly | Specialist/Technologist | 5th St and Roosevelt, Bldg 113, Hines, IL 60141 | 2007-03-22 |
| 1336220763 | Ernest Staines | Specialist/Technologist | 5 Th Avenue & Roosevelt Road, Building 113, Hines Veterans Hospital, Hines, IL 60141 | 2006-10-19 |
| 1962502039 | Kathryn A Helbing-smith | Specialist/Technologist | 5th & Roosevelt, Bldg 113, Blind Rehabilitation Center, Hines Va Hospital, Hines, IL 60141-5000 | 2006-09-25 |
| 1407955289 | Jennifer Molodecki | Specialist/Technologist | 5th and Roosevelt Rd, Building 113, Hines Va Hospital, Hines, IL 60141 | 2006-09-21 |
| 1154428571 | Samuel Janusauskas | Specialist/Technologist | Bldg 113, Hines Va Hospital, Hines, IL 60141 | 2006-09-20 |
| 1386741734 | Susan Ellen Soderquist Knauff | Specialist/Technologist | Building 113, 5th Ave. and Roosevelt Rd., Hines, IL 60141 | 2006-09-20 |
| 1801992169 | Deborah Lynn Zufan | Specialist/Technologist | 5th & Roosevelt Road, Hines, IL 60141-5000 | 2006-09-15 |
| 1457456766 | Sudhakar Pisipati | Specialist/Technologist | 5th & Roosvelt Road, Hines, IL 60141-5000 | 2006-09-13 |
| 1982610390 | Barbara Jean Hunt | Specialist/Technologist | Roosevelt and Fifth Avenue, Hines, IL 60141 | 2006-07-31 |
| Find all providers in HINES | ||||
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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.