Individual provider Active NPI

Lauren Brunetti

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1104426212
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021994 Issued in IL
Practice address
725 W Montrose Ave
Chicago, IL 60613-1515
Phone
(773) 929-1700
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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 149.021994 IL Primary

Addresses

Primary practice location

725 W Montrose Ave
Chicago, IL 60613-1515

Mailing address

519 W Melrose St Apt 514
Chicago, IL 60657-3786
Phone (219) 796-7710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021994ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Nov 1, 2020 Accepting new patients

Locations

725 W Montrose Ave
Chicago, IL 60613
Phone (773) 929-1700

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

3450 Oakton St
Skokie, IL 60076

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1104426212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 W MELROSE ST APT 514",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573786",
            "telephone_number": "219-796-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131515",
            "telephone_number": "773-929-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNETTI",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.