Individual provider Active NPI

Emily Anne Corson

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1073334058
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027918 Issued in IL
Practice address
145 S Virginia St
Crystal Lake, IL 60014-7226
Phone
(815) 444-9999
NPI assigned
Oct 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 149027918 IL Primary

Addresses

Primary practice location

145 S Virginia St
Crystal Lake, IL 60014-7226

Mailing address

242 Bristol St
Canandaigua, NY 14424-1621

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
I20250110000702 IL Practitioner - Clinical Social Worker 5395273916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mathers Clinic LLCGroup PAC ID 7214111582, 21 clinicians

Practice addresses (Care Compare)

145 S Virginia St
Crystal Lake, IL 60014-7226
Phone (815) 444-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mathers Clinic LLC Current Accepting new patients
The Mathers Clinic LLC CurrentSince Nov 9, 2024 Accepting new patients

Locations

145 S Virginia St
Crystal Lake, IL 60014
Phone (815) 397-7654

145 S Virginia St
Ste C
Crystal Lake, IL 60014
Phone (815) 363-6055

Organizations & group practices 2

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1073334058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 BRISTOL ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147226",
            "telephone_number": "815-444-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSON",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.