1. Home
  2. Directory
  3. Illinois
  4. Chicago
  5. Psychiatry Neurology
  6. NPI Profile

JENNIFER PHAN
NPI 1376003509
Psychiatry & Neurology - Psychiatry in Chicago, IL

Active since March 22, 2019PECOS EnrolledAccepts Medicare Assignment
4753 N BROADWAY ST STE 403, CHICAGO, IL 60640(773) 989-2780 Get Directions Write a Review

NPPES record last updated: June 11, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 11, 2024, Mar 22, 2019 (2 updates tracked since 2019).

About Jennifer Phan NPPES

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

JENNIFER PHAN (NPI 1376003509) is an individual psychiatry provider in Chicago, Illinois, licensed in Illinois (036.164537) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (2019).

NPPES Registry Identity

NPI1376003509
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameJENNIFER PHAN
Location Address4753 N BROADWAY ST STE 403Chicago, IL 60640-7910
Mailing Address4753 N Broadway St Ste 403Chicago, IL 60640-7910 · (773) 989-2780
Phone(773) 989-2780
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2019
Enumeration DateMarch 22, 2019
Last NPPES UpdateJune 11, 20242 updates tracked since enumeration
NPPES CertifiedJune 11, 2024
✔ NPI 1376003509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in IL · 036.164537
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
4753 N BROADWAY ST STE 403, Chicago, IL 60640
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer Phan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244691863
PECOS Enrollment IDI20241014003473
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.

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Phan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Optum Behavioral Care Of Colorado, P.C.
Same address
Clinical
4753 N BROADWAY ST STE 403
Chicago, IL 60640
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Optum Behavioral Care Of Colorado PC
  • 6 clinicians in this Medicare group
NPI 1023888450 (704) 506-6267

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60640 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$183.39 typical visit price
range $60.08 – $183.39
Typical copayment $45.84 (range $15.02 – $45.84)
Most-billed visit code 99205
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

DR. ANDREW WANG M.D.
Psychiatry & Neurology (Psychiatry)
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (773) 989-2780
OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Psychologist (Clinical)
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (704) 506-6267
MARGARITA KOS PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (773) 989-2780
ANJUM F KHAN NP
Nurse Practitioner
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (773) 989-2780
MS. SAMANTHA LEIGH KARREL LCSW
Social Worker (Clinical)
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (739) 892-7807
GIANG DIN NGUYEN
Nurse Practitioner (Psychiatric/Mental Health)
4753 N BROADWAY ST STE 403
CHICAGO, IL 60640
Cook County (773) 989-2780

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 Jennifer Phan's NPI number?

The NPI number for Jennifer Phan is 1376003509. It was assigned to this individual provider in the NPPES registry on March 22, 2019.

Where is Jennifer Phan located?

Jennifer Phan practices at 4753 N Broadway St Ste 403, Chicago, IL 60640. The listed phone number is (773) 989-2780.

What is Jennifer Phan's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Jennifer Phan enrolled in Medicare?

Yes. Jennifer Phan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jennifer Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Phan reassigns Medicare benefits to Optum Behavioral Care Of Colorado, P.C. (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Phan accept?

Health plans from Oscar Health and UnitedHealthcare list Jennifer Phan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Phan was last updated on June 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.