Individual provider Active NPI

Alice K Virgil, LCSW

  • Clinical Social Worker
  • Lake Bluff, IL
National Provider Identifier
1003969247
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.010380 Issued in IL
Practice address
900 W North Shore Dr Ste 210
Lake Bluff, IL 60044-2251
Phone
(773) 919-9170
Fax
(773) 919-9170
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.010380 IL Primary

Addresses

Primary practice location

900 W North Shore Dr Ste 210
Lake Bluff, IL 60044-2251

Mailing address

12979 W Sanctuary CT
Lake Bluff, IL 60044-1139
Phone (773) 919-9170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.010380ILMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1003969247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12979 W SANCTUARY CT",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441139",
            "telephone_number": "773-919-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NORTH SHORE DR STE 210",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442251",
            "telephone_number": "773-919-9170",
            "fax_number": "773-919-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRGIL",
        "first_name": "ALICE",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Bluff, IL

Sources for this page

Verify at the official NPI Registry.