Active NPI
Jean Ackermans
- Clinical Social Worker
- Mt Prospect, IL
National Provider Identifier
1104290345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014492
- Practice address
- 800 E Northwest Hwy
106
Mt Prospect, IL 60056-3457 - Phone
- (847) 909-9858
- NPI assigned
- Nov 27, 2015
- 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 | 149.014492 | IL | Primary |
Addresses
Primary practice location
800 E Northwest Hwy
106
Mt Prospect, IL 60056-3457
Mailing address
1311 Longacre LN
Wheeling, IL 60090-5930
Phone (773) 338-3459
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160208000706 | IL | Practitioner - Clinical Social Worker | 3870897192 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 91.66 of 100
- Quality
- 80.64
- Improvement activities
- 40
- Cost
- 74.35
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.014492 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Lake | Current | Accepting new patients | |
| County of Lake | Current | Accepting new patients | |
| County of Lake | Current | Accepting new patients | |
| Deer Oaks Mid-West LLC | Current | Accepting new patients |
Locations
720 Raymond Dr
Naperville, IL 60563
Phone (630) 355-0220
2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400
3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Waukegan, IL
- NPI 1376717702
-
- Federally Qualified Health Center (FQHC)
- Round Lake, IL
- NPI 1639588254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453420800000",
"number": "1104290345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 LONGACRE LN",
"city": "WHEELING",
"state": "IL",
"postal_code": "600905930",
"telephone_number": "773-338-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E NORTHWEST HWY",
"address_2": "106",
"city": "MT PROSPECT",
"state": "IL",
"postal_code": "600563457",
"telephone_number": "847-909-9858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMANS",
"first_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-27",
"last_updated": "2016-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mt Prospect, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.