Individual provider Active NPI

Sandra Hunter Bass

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104227313
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017928 Issued in IL
Practice address
8407 S Constance Ave
Chicago, IL 60617-2218
Phone
(773) 656-4358
NPI assigned
Sep 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.017928 IL Primary
Clinical Social Worker 1041C0700X 34007290A IN

Addresses

Primary practice location

8407 S Constance Ave
Chicago, IL 60617-2218

Mailing address

8407 S Constance Ave
Chicago, IL 60617-2218
Phone (773) 656-4358

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
I20150911001120 IL Practitioner - Clinical Social Worker 6305150079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6127 S University Ave
Suite 1250
Chicago, IL 60637-7505
Phone 31272124712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017928ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resk Residential Services Inc, Past Accepting new patients
Resk Residential Services Inc, Past Accepting new patients

Organizations & group practices 3

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": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1104227313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8407 S CONSTANCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172218",
            "telephone_number": "773-656-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8407 S CONSTANCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172218",
            "telephone_number": "773-656-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER BASS",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-07",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017928",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007290A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.