JASON ROOSEVELT BRUSA NPI 1922728047

NPI Information

  • NPI: 1922728047
  • Provider Name: JASON ROOSEVELT BRUSA
  • Classification: Recreation Therapist - 225800000X
  • Entity Type: Individual
  • Address: 820 S DAMEN AVE
    CHICAGO, IL
    ZIP 60612
  • Phone: (312) 569-9502

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NPI Details

Jason Roosevelt Brusa is a recreation therapist in Chicago, IL. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Jason Roosevelt Brusa NPI is 1922728047. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

820 S DAMEN AVE
CHICAGO, IL
ZIP 60612-728
Phone: (312) 569-9502

The enumeration date for this NPI number is 8/30/2022 and was last updated on 8/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225800000XRecreation Therapist56129ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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