Active NPI
Nancy Levy Simon
- Clinical Social Worker
- Evanston, IL
National Provider Identifier
1093136483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149005243
- Practice address
- 1740 Ridge Ave Ste 101
Evanston, IL 60201-5908 - Phone
- (847) 491-1111
- NPI assigned
- Jan 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 149005243 | IL | Primary |
Addresses
Primary practice location
1740 Ridge Ave Ste 101
Evanston, IL 60201-5908
Mailing address
1740 Ridge Ave Ste 101
Evanston, IL 60201-5908
Phone (847) 491-1111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 3, 2020 through Feb 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149005243 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1093136483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 RIDGE AVE STE 101",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015908",
"telephone_number": "847-491-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 RIDGE AVE STE 101",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015908",
"telephone_number": "847-491-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "NANCY",
"middle_name": "LEVY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-02",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149005243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.