Organization Active NPI

Intermission Therapies, LTD.

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1124125752
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INTERMISSION THERAPIES, LTD.
Practice address
22 Crissey Ave Ste 200
Geneva, IL 60134-2351
Phone
(630) 232-7770
NPI assigned
Sep 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Mrs. Marie S Egeland, LCSWNPI 1578646451
Title
President
Phone
(630) 232-7770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

22 Crissey Ave Ste 200
Geneva, IL 60134-2351

Mailing address

22 Crissey Ave Ste 200
Geneva, IL 60134-2351
Phone (630) 232-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090212000649 IL Part B Supplier - Clinic/Group Practice 2860557592 Receives reassigned benefits from 2 practitioners
Practice locations: Geneva, IL

National Provider Directory

National Provider Directory

Locations

22 Crissey Ave
Ste 200
Geneva, IL 60134
Phone (630) 232-7770

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1124125752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CRISSEY AVE STE 200",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342351",
            "telephone_number": "630-232-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CRISSEY AVE STE 200",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342351",
            "telephone_number": "630-232-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMISSION THERAPIES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "EGELAND",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-232-7770",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.