Individual provider Active NPI

Jean Ackermans

  • Clinical Social Worker
  • Mt Prospect, IL
National Provider Identifier
1104290345
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014492 Issued in IL
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

Updated by the provider on Jan 22, 2016

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208000706 IL Practitioner - Clinical Social Worker 3870897192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.66 of 100Reported as group
Quality
80.64
Improvement activities
40
Cost
74.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014492ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake CurrentSince Sep 11, 2023 Accepting new patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Sep 11, 2023 Accepting new patients
Deer Oaks Mid-West LLC CurrentSince Nov 15, 2024 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.

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

Verify at the official NPI Registry.