Individual provider Active NPI

Erin Vanden Brook, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1053847624
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018731 Issued in IL
Practice address
645 N Kingsbury St
Unit 2102
Chicago, IL 60654-6940
Phone
(608) 577-8028
NPI assigned
May 2, 2017
Last updated
May 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2017

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 149018731 IL Primary

Addresses

Primary practice location

645 N Kingsbury St
Unit 2102
Chicago, IL 60654-6940

Mailing address

645 N Kingsbury St
Unit 2102
Chicago, IL 60654-6940
Phone (608) 577-8028

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
149018731ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1053847624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N KINGSBURY ST",
            "address_2": "UNIT 2102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546940",
            "telephone_number": "608-577-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 N KINGSBURY ST",
            "address_2": "UNIT 2102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546940",
            "telephone_number": "608-577-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN BROOK",
        "first_name": "ERIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018731",
            "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 May 2, 2017; 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.