Wanda Hill
Individual provider Active NPI Social Worker · Du Quoin, IL
NPI 1023405461 · NPPES record last updated Apr 23, 2015
Key facts
- NPI
- 1023405461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 150015616 (IL)
- Practice address
- 1016 S Madison St Ste a
Du Quoin, IL 62832-2442 - Phone
- (618) 542-4357
- Fax
- (618) 542-3442
- NPI assigned
- Apr 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MO, IL, IN, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251119003279 | MO | Practitioner - Clinical Social Worker | 4082106877 | Reassigns benefits to 1 organization |
| I20251121002115 | IL | Practitioner - Clinical Social Worker | 4082106877 | Reassigns benefits to 1 organization |
| I20251124004316 | IN | Practitioner - Clinical Social Worker | 4082106877 | Reassigns benefits to 1 organization |
| I20251201002165 | DC | Practitioner - Clinical Social Worker | 4082106877 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150015616 | IL | MD | Social Worker |
Practice roles (1 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338
9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646
4625 Lindell Blvd
Ste 200
Saint Louis, MO 63108
Phone (314) 833-8765
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
- IA HMO C-SNP
- IA HMO
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150015616 | IL | Yes |
Addresses
Primary practice location
1016 S Madison St Ste a
Du Quoin, IL 62832-2442
Mailing address
1016 S Madison St Ste a
Du Quoin, IL 62832-2442
Phone (618) 542-4357
Other providers in Du Quoin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.