Elizabeth Heideman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018243 Issued in IL

Practice address

2525 W Peterson Ave
Chicago, IL 60659-4108

Phone

(872) 235-0880

NPI assigned

Feb 24, 2016

Last updated

Feb 24, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Wallace Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1093175762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 N SEDGWICK ST",
            "address_2": "APT. 2W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594108",
            "telephone_number": "872-235-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEMAN",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WALLACE",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jonathan Heiberger, LPC
• Alyssa Christian Heick
• Sara Ogawa Heidbreder, LCPC, BC-DMT
• Bryan Heidel, LCPC
• Jonah Heidel, MD
• Jean L Heideman, APN
• Katherine Elizabeth Heideman, APRN
• Katherine Bernadette Heiden, MD
• Jodi K. Heidenreich
• Ronald A. Heiderman, D.D.S.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.