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NPI Code Detail

MEDICARE: JACK VERVERIS

MEDICARE: JACK VERVERIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1104775527
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK VERVERIS
Provider Business Mailing Address
First Line : 22 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1607
Country : US
Telephone Number : 615-979-2745
Fax Number :
Provider Business Practice Location Address
First Line : 22 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1607
Country : US
Telephone Number : 615-979-2745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 05/27/2026

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Directions to “ JACK VERVERIS ” Practice Location

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