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JA'NEIL GRACE-MARIE HUMPHREY MD
NPI 1205626066
Student in an Organized Health Care Education/Training Program in Chicago, IL

Active since May 07, 2025PECOS Enrolled
811 S PAULINA ST, CHICAGO, IL 60612(312) 355-5338 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Ja'neil Grace-marie Humphrey Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JA'NEIL GRACE-MARIE HUMPHREY MD (NPI 1205626066) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205626066
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJA'NEIL GRACE-MARIE HUMPHREYCredential: MD
Location Address811 S PAULINA STChicago, IL 60612-4353
Mailing Address811 S Paulina StChicago, IL 60612-4353 · (312) 355-5338
Phone(312) 355-5338
Sole ProprietorNo
Enumeration DateMay 7, 2025
NPPES CertifiedMay 7, 2025
✔ NPI 1205626066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
811 S PAULINA ST, Chicago, IL 60612
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ja'neil Grace-marie Humphrey Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROSEMARY SEELAUS M.A.M.S.
Anaplastologist
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-7546
SVEN GARTNER DDS
Dentist (General Practice)
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-7546
DR. POLINA GEORGIEVNA GUBAREVA
Student in an Organized Health Care Education/Training Program
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-7555
MISS SYLVIA DOMINGUEZ MSW, LSW
Social Worker
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 355-5408
DR. JANINE ROSENBERG PH.D.
Psychologist (Clinical Child & Adolescent)
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-1137
ERIN STEVENS
Anaplastologist
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-7546
ELLYN MCNAMARA
Speech-Language Pathologist
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-7546
STACY NICOLE CASH M.A., CCC-SLP
Speech-Language Pathologist
811 S PAULINA ST
CHICAGO, IL 60612
Cook County (312) 996-1136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ja'neil Humphrey's NPI number?

The NPI number for Ja'neil Humphrey is 1205626066. It was assigned to this individual provider in the NPPES registry on May 7, 2025.

Where is Ja'neil Humphrey located?

Ja'neil Humphrey practices at 811 S Paulina St, Chicago, IL 60612. The listed phone number is (312) 355-5338.

What is Ja'neil Humphrey's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ja'neil Humphrey enrolled in Medicare?

Yes. Ja'neil Humphrey is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ja'neil Humphrey was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.