Tara Arianne Tillman, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016360 Issued in IL

Practice address

1509 W Berwyn Ave
201B
Chicago, IL 60640-8056

Phone

(702) 526-9022

Fax

(312) 940-1958

NPI assigned

Oct 29, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Salt & Sand Psychotherapy PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1174380786
  NPD Authorized official

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459641600000",
    "number": "1124490115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 W PRATT BLVD APT 3S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606266045",
            "telephone_number": "702-526-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 W BERWYN AVE",
            "address_2": "201B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606408056",
            "telephone_number": "702-526-9022",
            "fax_number": "312-940-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "TARA",
        "middle_name": "ARIANNE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2016-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvin Thomas Tillman, PHD, MA
• Rachel L Tillman, M.A.
• Roy Jean Tillman
• Sasah Irene Tillman, LMFT
• Stephanie Nicole Tillman, CNM
• Melisa Lynn Tillner, DDS
• Kimberly Jo Tillotson-McManus, LCSW
• Tilmans Community Health Clinic, Inc
• Jacob D Tilsley, DPM
• Justine Andrea Tilson, PT, DPT

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2016; 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.