Individual provider Active NPI

Rowyn Kruiswyk

  • Social Worker
  • Chicago, IL
National Provider Identifier
1063276624
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1757 N Kimball Ave Ste 202
Chicago, IL 60647-4805
Phone
(312) 278-3447
NPI assigned
Feb 13, 2024
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X Primary

Addresses

Primary practice location

1757 N Kimball Ave Ste 202
Chicago, IL 60647-4805

Mailing address

505 S Busey Ave Apt 408
Urbana, IL 61801-7905

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sithub Dba Chicago Therapy Collective PastSince Feb 18, 2024 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, 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": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1063276624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S BUSEY AVE APT 408",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618017905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 N KIMBALL AVE STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474805",
            "telephone_number": "312-278-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUISWYK",
        "first_name": "ROWYN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "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 Feb 13, 2024; 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.