Individual provider Active NPI

Jesus Salazar, MSW, LSW

  • Social Worker
  • Crystal Lake, IL
National Provider Identifier
1063210300
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.114970 Issued in IL
Practice address
850 S McHenry Ave Ste a
Crystal Lake, IL 60014-7442
Phone
(815) 455-6124
NPI assigned
Mar 4, 2025
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.114970 IL Primary

Addresses

Primary practice location

850 S McHenry Ave Ste a
Crystal Lake, IL 60014-7442

Mailing address

529 Fremont St
Woodstock, IL 60098-4066
Phone (217) 220-7479

Other practice location 1

500 Coventry Ln Ste 260
Crystal Lake, IL 60014-7592
Phone (872) 269-0115

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
I20260417001553 IL Practitioner - Clinical Social Worker 0941776819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1401 McHenry Rd
Suite 122
Buffalo Grove, IL 60089-1382

529 Fremont St
Woodstock, IL 60098-4066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.114970ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Counseling Center,LTD Past Accepting new patients

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": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1063210300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 FREMONT ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600984066",
            "telephone_number": "217-220-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S MCHENRY AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147442",
            "telephone_number": "815-455-6124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Coventry Ln Ste 260",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147592",
            "country_code": "US",
            "telephone_number": "872-269-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "JESUS",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.114970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.