Individual provider Active NPI

Ivan Cecil James IV, MSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104135029
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027003 Issued in IL
Practice address
8023 S Indiana Ave
Apt 2
Chicago, IL 60619-3506
Phone
(773) 317-4900
NPI assigned
Sep 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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 149027003 IL Primary

Addresses

Primary practice location

8023 S Indiana Ave
Apt 2
Chicago, IL 60619-3506

Mailing address

5644 S Oakley Ave
Chicago, IL 60636-1025
Phone (773) 317-4900

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
I20251010000466 IL Practitioner - Clinical Social Worker 3072010438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11033 S State St
Chicago, IL 60628-4495

6008 Ridgeway Dr
Woodridge, IL 60517-1027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149027003ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Forest Psychological Service Clinical CurrentSince Sep 29, 2025 Accepting new patients
Oak Forest Psychological Service Clinical CurrentSince Sep 29, 2025 Accepting new patients

Locations

160 W 10th St
Chicago Hts, IL 60411
Phone (708) 754-2220

6502 Joliet Rd
Countryside, IL 60525
Phone (708) 215-8400

6502 Joliet Rd
Fl 2
Countryside, IL 60525
Phone (708) 215-8400

13901 S Lydia Ave
Robbins, IL 60472
Phone (708) 385-5642

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": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1104135029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5644 S OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606361025",
            "telephone_number": "773-317-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8023 S INDIANA AVE",
            "address_2": "APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606193506",
            "telephone_number": "773-317-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "IVAN",
        "middle_name": "CECIL",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-27",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.