Individual provider Active NPI

Tami Sollo, LCSW

  • Clinical Social Worker
  • Glencoe, IL
National Provider Identifier
1013144112
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-0003630 Issued in IL
Practice address
675 Village CT
Glencoe, IL 60022-1609
Phone
(847) 835-5111
NPI assigned
Jun 16, 2009
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 149-0003630 IL Primary

Addresses

Primary practice location

675 Village CT
Glencoe, IL 60022-1609

Mailing address

675 Village CT
Glencoe, IL 60022-1609
Phone (847) 835-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525000687 IL Practitioner - Clinical Social Worker 9032248331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Service of GlencoeGroup PAC ID 4880953082, 4 clinicians

Practice addresses (Care Compare)

361 Park Ave
Suite 202
Glencoe, IL 60022-1585
Phone (847) 835-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-0003630ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of Glencoe Counselor CurrentSince May 1, 2023 Accepting new patients

Locations

320 Tudor Ct
#2
Glencoe, IL 60022

361 Park Ave
Ste 202
Glencoe, IL 60022
Phone (847) 835-5111

675 Village Ct
Glencoe, IL 60022
Phone (847) 835-4112

675 Village Ct
Ste 2
Glencoe, IL 60022
Phone (847) 835-5111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1013144112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 VILLAGE CT",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221609",
            "telephone_number": "847-835-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 VILLAGE CT",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221609",
            "telephone_number": "847-835-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLO",
        "first_name": "TAMI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-0003630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glencoe, IL

Sources for this page

Verify at the official NPI Registry.