Active NPI
Brittany Gardner
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1023687704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.022343
- Practice address
- 2000 N Racine Ave Ste 3300
Chicago, IL 60614-4045 - Phone
- (773) 413-9523
- NPI assigned
- Jun 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.022343 | IL | Primary |
Addresses
Primary practice location
2000 N Racine Ave Ste 3300
Chicago, IL 60614-4045
Mailing address
2122 N Kimball Ave
Chicago, IL 60647-3512
Phone (708) 969-5282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.022343 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abbie Kelley, LLC | Current | Accepting new patients |
Locations
2000 N Racine Ave
Ste 3300
Chicago, IL 60614
Phone (773) 413-9523
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1023687704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 N KIMBALL AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606473512",
"telephone_number": "708-969-5282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N RACINE AVE STE 3300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606144045",
"telephone_number": "773-413-9523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "BRITTANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.022343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.