Active NPI
Nathan P Dougal, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1063565653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 3166 N Lincoln Ave
Suite 216
Chicago, IL 60657 - Phone
- (773) 348-1234
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3166 N Lincoln Ave
Suite 216
Chicago, IL 60657
Mailing address
1234 N Kedzie Ave
Chicago, IL 60651
Phone (773) 394-1234
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063565653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1234 N KEDZIE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60651",
"telephone_number": "773-394-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3166 N LINCOLN AVE",
"address_2": "SUITE 216",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60657",
"telephone_number": "773-348-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGAL",
"first_name": "NATHAN",
"middle_name": "P",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.