Individual provider Active NPI

Greg Bahnfleth

  • Social Worker
  • McHenry, IL
National Provider Identifier
1033820022
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
4031 W Dayton St
McHenry, IL 60050-8377
Phone
(815) 344-1230
NPI assigned
Dec 9, 2022
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

4031 W Dayton St
McHenry, IL 60050-8377

Mailing address

4031 W Dayton St
McHenry, IL 60050-8377
Phone (815) 344-1230

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 9, 2022.

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1033820022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 W DAYTON ST",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508377",
            "telephone_number": "815-344-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 W DAYTON ST",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508377",
            "telephone_number": "815-344-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHNFLETH",
        "first_name": "GREG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.