Individual provider Active NPI

Christopher Jay Fox, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1104970581
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010583 Issued in IL
Practice address
120 S Marion St
Oak Park, IL 60302-2809
Phone
(708) 383-7500
Fax
(708) 383-7780
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801117776 MI
Clinical Social Worker 1041C0700X 149010583 IL Primary

Addresses

Primary practice location

120 S Marion St
Oak Park, IL 60302-2809

Mailing address

120 S Marion St
Oak Park, IL 60302-2809
Phone (708) 383-7500

Other practice location 1

1010 N Madison Ave
Bay City, MI 48708-5926
Phone (708) 207-8076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240508001198 MI Practitioner - Clinical Social Worker 1052218310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bay-Arenac Behavioral HealthGroup PAC ID 5496706228, 30 clinicians

Practice addresses (Care Compare)

201 Mulholland St
Bay City, MI 48708-7693
Phone (989) 895-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010583ILMDClinical Social Worker
6801117776MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bay-Arenac Behavioral Health CurrentSince Apr 24, 2024 Accepting new patients

Locations

1010 N Madison Ave
Bay City, MI 48708
Phone (989) 895-2200

201 Mulholland St
Bay City, MI 48708
Phone (989) 895-2222

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1104970581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500",
            "fax_number": "708-383-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500",
            "fax_number": "708-383-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 N Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487085926",
            "country_code": "US",
            "telephone_number": "708-207-8076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117776",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.