Individual provider Active NPI

Elita Wolsk, MA LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1114067865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
561 W Diversay Parkway
Suite 216
Chicago, IL 60614-1682
Phone
(773) 528-0941
Fax
(847) 679-0780
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

561 W Diversay Parkway
Suite 216
Chicago, IL 60614-1682

Mailing address

561 W Diversay Parkway
Suite 216
Chicago, IL 60614-1682
Phone (773) 528-0941

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
I20090618000472 IL Practitioner - Clinical Social Worker 5799835476 Practice locations: Skokie, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7430 Kilbourn Ave
Skokie, IL 60076-3842
Phone (773) 528-0941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
149001969ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114067865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 W DIVERSAY PARKWAY",
            "address_2": "SUITE 216",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141682",
            "telephone_number": "773-528-0941",
            "fax_number": "847-679-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 W DIVERSAY PARKWAY",
            "address_2": "SUITE 216",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141682",
            "telephone_number": "773-528-0941",
            "fax_number": "847-679-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLSK",
        "first_name": "ELITA",
        "credential": "MA LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.