Alexandra Tatooles, LCSW, ACM-SW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.023113 Issued in IL

Practice address

1938 N Leavitt St # 1
Chicago, IL 60647-4456

Phone

(312) 203-1812

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931
  Medicare reassignment NPD

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1033996434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 N LEAVITT ST # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474456",
            "telephone_number": "312-203-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 N LEAVITT ST # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474456",
            "telephone_number": "312-203-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATOOLES",
        "first_name": "ALEXANDRA",
        "credential": "LCSW, ACM-SW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura M Tatgenhorst
• Tatiana Rohner LLC
• Milena Tatic-Bajich, PSYD
• Tatjana K Pavlovic, MD SC
• Tatjana Pavlovic M.D.
• Nicole Tatsuguchi-Ongcal, DC
• Jessica Grace Tatsui
• Diane Tattegrain
• Alexander Kyle Tatum
• Angel Nicole Tatum, LSW

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.