Individual provider Active NPI

Eden Fultz, MA, LSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1093660136
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150118459 Issued in IL
Practice address
25 E Washington St Ste 1458
Chicago, IL 60602-1856
Phone
(708) 568-1344
NPI assigned
Mar 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150118459 IL Primary

Addresses

Primary practice location

25 E Washington St Ste 1458
Chicago, IL 60602-1856

Mailing address

25 E Washington St Ste 1458
Chicago, IL 60602-1856

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
150118459ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1093660136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1458",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1458",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021856",
            "telephone_number": "708-568-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "EDEN",
        "credential": "MA, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150118459",
            "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 Mar 3, 2026; 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.