Individual provider Active NPI

Edina Setsuko Taerbaum

  • Social Worker
  • Chicago, IL
National Provider Identifier
1023960630
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.118976 Issued in IL
Practice address
3110 W Grand Ave
Chicago, IL 60622-4324
Phone
(847) 909-3981
NPI assigned
Feb 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.118976 IL Primary

Addresses

Primary practice location

3110 W Grand Ave
Chicago, IL 60622-4324

Mailing address

7831 Kildare Ave
Skokie, IL 60076-3515
Phone (847) 909-3981

Other practice location 1

1551 W 95th St
Chicago, IL 60643-1329
Phone (847) 909-3981

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

LicenseStateTypeSpecialty
150.118976ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1771027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1023960630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7831 KILDARE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763515",
            "telephone_number": "847-909-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224324",
            "telephone_number": "847-909-3981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1551 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606431329",
            "country_code": "US",
            "telephone_number": "847-909-3981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAERBAUM",
        "first_name": "EDINA",
        "middle_name": "SETSUKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-14",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.118976",
            "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 Feb 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.