Individual provider Active NPI

Carol Phillips Hamilton, LCSW

  • Clinical Social Worker
  • Libertyville, IL
National Provider Identifier
1124330378
Registry record updated Jul 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.007691 Issued in IL
Practice address
1512 Artaius Pkwy Ste 300
Libertyville, IL 60048-5231
Phone
(847) 604-1991
NPI assigned
Jul 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2010

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 149.007691 IL Primary

Addresses

Primary practice location

1512 Artaius Pkwy Ste 300
Libertyville, IL 60048-5231

Mailing address

1615 N Wolcott Ave Unit 204
Chicago, IL 60622-1323
Phone (773) 531-1529

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
I20140502001029 IL Practitioner - Clinical Social Worker 9032342787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

53 W Jackson Blvd
Suite 626
Chicago, IL 60604-3444
Phone (773) 531-1529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.007691ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carol Phillips Hamilton LCSW PC Clinical CurrentSince May 8, 2019 Accepting new patients

Locations

53 W Jackson Blvd
Ste 626
Chicago, IL 60604
Phone (773) 469-6299

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": "1278115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278115200000",
    "number": "1124330378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N WOLCOTT AVE UNIT 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221323",
            "telephone_number": "773-531-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 ARTAIUS PKWY STE 300",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485231",
            "telephone_number": "847-604-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "CAROL",
        "middle_name": "PHILLIPS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-03",
        "last_updated": "2010-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.007691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.