Individual provider Active NPI

Asia Craig

  • Clinical Social Worker
  • University Park, IL
National Provider Identifier
1104699305
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15011024 Issued in IL
Practice address
619 Old Forge LN
University Park, IL 60484-3327
Phone
(708) 374-5099
NPI assigned
Oct 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 15011024 IL Primary

Addresses

Primary practice location

619 Old Forge LN
University Park, IL 60484-3327

Mailing address

619 Old Forge LN
University Park, IL 60484-3327
Phone (708) 374-5099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15011024ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1104699305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 OLD FORGE LN",
            "city": "UNIVERSITY PARK",
            "state": "IL",
            "postal_code": "604843327",
            "telephone_number": "708-374-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 OLD FORGE LN",
            "city": "UNIVERSITY PARK",
            "state": "IL",
            "postal_code": "604843327",
            "telephone_number": "708-374-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "ASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "15011024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.