Individual provider Active NPI

Camisha Martin

  • Clinical Social Worker
  • Chicago Heights, IL
National Provider Identifier
1083357685
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027796 Issued in IL
Practice address
1401 Western Ave
Chicago Heights, IL 60411-3147
Phone
(708) 292-7000
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 150106147 IL
Clinical Social Worker 1041C0700X 149.027796 IL Primary

Addresses

Primary practice location

1401 Western Ave
Chicago Heights, IL 60411-3147

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 352-1515

Other practice location 1

10801 S Harlem Ave Apt 1N
Worth, IL 60482-1161
Phone (312) 905-3411

Other practice location 2

1550 S Indiana Ave Ste 2Ne
Chicago, IL 60605-2857
Phone (773) 377-5577

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
I20241023000079 IL Practitioner - Clinical Social Worker 5395278808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1401 Western Ave
Chicago Heights, IL 60411-3147
Phone (708) 292-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150106147ILMDSocial Worker
149.027796ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ashe Counseling & Coaching LLC Clinical CurrentSince Apr 1, 2022 Accepting new patients
Oak Street Health Physicians Group, PC CurrentSince Sep 24, 2024 Accepting new patients

Locations

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

1550 S Indiana Ave
Ste 2NE
Chicago, IL 60605
Phone (773) 377-5577

1401 Western Ave
Chicago Heights, IL 60411
Phone (708) 292-7000

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": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1083357685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WESTERN AVE",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113147",
            "telephone_number": "708-292-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10801 S Harlem Ave Apt 1N",
            "address_purpose": "LOCATION",
            "city": "Worth",
            "state": "IL",
            "postal_code": "604821161",
            "country_code": "US",
            "telephone_number": "312-905-3411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 S Indiana Ave Ste 2Ne",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606052857",
            "country_code": "US",
            "telephone_number": "773-377-5577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAMISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150106147",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

Verify at the official NPI Registry.