Individual provider Active NPI

Yadira Chavez

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104307966
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1431 N Claremont Ave
Chicago, IL 60622-1702
Phone
(312) 491-5408
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1431 N Claremont Ave
Chicago, IL 60622-1702

Mailing address

4000 W Montrose Ave
Chicago, IL 60641-2140
Phone (312) 508-3951

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
I20230818003105 IL Practitioner - Clinical Social Worker 9537521778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glaser and Associates LLCGroup PAC ID 2365774718, 13 clinicians

Practice addresses (Care Compare)

1431 N Claremont
1St Floor Pavilion
Chicago, IL 60622
Phone (312) 491-5498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Glaser and Associates LLC Multi-Specialty CurrentSince Aug 15, 2023 Accepting new patients

Locations

1431 N Claremont Ave
Fl 1
Chicago, IL 60622
Phone (312) 491-5498

1431 N Claremont Ave
Chicago, IL 60622
Phone (312) 491-5498

1431 N Western Ave
Ste 306
Chicago, IL 60622
Phone (312) 332-2226

6428 Joliet Rd
Ste 201
Countryside, IL 60525

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1104307966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412140",
            "telephone_number": "312-508-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-491-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "YADIRA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.