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General NPI Number Information
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NPI Number | 1497188106
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Entity Type | Individual
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Provider Name | JASON D SWEAZY MS, BSN, BA, PMHNP
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Gender | Male
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 1457 N HALSTED ST UNIT B303
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City | CHICAGO
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State | IL
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Zip | 60642-2677
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Country | US
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Telephone | 888-428-7890
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Fax | 877-428-7891
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Provider Business Mailing Address
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Address Line | 812 W JUNIOR TER APT 2
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City | CHICAGO
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State | IL
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Zip | 60613-5098
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Country | US
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Telephone | 512-992-8808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.524448
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 757959
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 198358
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 36768.1471
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License Number State | WY
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN.0992019-NP
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License Number State | CO
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402523
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277.002535
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.025514
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License Number State | IL
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