Active NPI
Senait Gebretsadik
- Clinical Social Worker
- Algonquin, IL
National Provider Identifier
1053843110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149018085
- Practice address
- 215 N Main St
Algonquin, IL 60102-2448 - Phone
- (224) 678-9033
- Fax
- (224) 678-9493
- NPI assigned
- Mar 29, 2017
- 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 | 149018085 | IL | Primary |
Addresses
Primary practice location
215 N Main St
Algonquin, IL 60102-2448
Mailing address
215 N Main St
Algonquin, IL 60102-2448
Phone (224) 678-9033
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149018085 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current | Accepting new patients | |
| Midwest Post Acute Care PLLC | Clinical | Current | Accepting new patients |
Locations
800 W Oakton St
Arlington Hts, IL 60004
Phone (847) 253-3710
2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437
332 S Michigan Ave
Chicago, IL 60604
Phone (773) 633-7479
Organizations & group practices 2
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": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1053843110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 N MAIN ST",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601022448",
"telephone_number": "224-678-9033",
"fax_number": "224-678-9493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N MAIN ST",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601022448",
"telephone_number": "224-678-9033",
"fax_number": "224-678-9493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEBRETSADIK",
"first_name": "SENAIT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-29",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149018085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.