Individual provider Active NPI

Janet Marie Mankoff

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1053927996
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012987 Issued in IL
Practice address
120 S Marion St
Oak Park, IL 60302-2809
Phone
(708) 383-7500
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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 149.012987 IL Primary

Addresses

Primary practice location

120 S Marion St
Oak Park, IL 60302-2809

Mailing address

120 S Marion St
Oak Park, IL 60302-2809
Phone (708) 383-7500

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260504007449 IL Practitioner - Clinical Social Worker 8325516792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

2124 Ogden Ave
Suite 301
Aurora, IL 60504-7542
Phone (630) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012987ILMDClinical Social Worker

Organizations & group practices 1

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1053927996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKOFF",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.