Individual provider Active NPI

Alexandra B Dembitz

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1033779699
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018463 Issued in IL
Practice address
1841 N California Ave Apt 3a
Chicago, IL 60647-7544
Phone
(847) 477-4499
NPI assigned
Jun 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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 149.018463 IL Primary

Addresses

Primary practice location

1841 N California Ave Apt 3a
Chicago, IL 60647-7544

Mailing address

1841 N California Ave Apt 3a
Chicago, IL 60647-7544
Phone (847) 477-4499

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
149.018463ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1033779699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 N CALIFORNIA AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606477544",
            "telephone_number": "847-477-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 N CALIFORNIA AVE APT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606477544",
            "telephone_number": "847-477-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBITZ",
        "first_name": "ALEXANDRA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018463",
            "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, 2019; 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.