Individual provider Active NPI

Alexia Diaz de Leon, LCSW

  • Clinical Social Worker
  • Elgin, IL
National Provider Identifier
1063061521
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.028586 Issued in IL
Practice address
1845 Grandstand PL
Elgin, IL 60123-6603
Phone
(847) 695-5496
NPI assigned
Sep 8, 2019
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.106545 IL
Clinical Social Worker 1041C0700X 149.028586 IL Primary

Addresses

Primary practice location

1845 Grandstand PL
Elgin, IL 60123-6603

Mailing address

1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484

Other practice location 1

5101 Washington St Ste 1102
Gurnee, IL 60031-2988
Phone (847) 802-8992

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
I20250331002061 IL Practitioner - Clinical Social Worker 6305369364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.106545ILMDSocial Worker
149.028586ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ecker Center for Behavioral Health CurrentSince Jan 10, 2025 Accepting new patients
Ecker Center for Behavioral Health CurrentSince Jan 10, 2025 Accepting new patients
Ecker Center for Behavioral Health Clinical Current Accepting new patients
Ecker Center for Behavioral Health Past Accepting new patients

Locations

1845 Grandstand Pl
Elgin, IL 60123

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1063061521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-5496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5101 Washington St Ste 1102",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600312988",
            "country_code": "US",
            "telephone_number": "847-802-8992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ DE LEON",
        "first_name": "ALEXIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.106545",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.