Active NPI
Josh Fraccaro, LSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1124602651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 150105143
- Practice address
- 1416 W Belmont Ave
Chicago, IL 60657-0939 - Phone
- (773) 799-8966
- NPI assigned
- May 11, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 150105143 | IL | Primary |
Addresses
Primary practice location
1416 W Belmont Ave
Chicago, IL 60657-0939
Mailing address
2407 W Eastwood Ave Apt 304
Chicago, IL 60625-4866
Phone (312) 505-6551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 12, 2025 through Sep 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150105143 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1124602651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2407 W EASTWOOD AVE APT 304",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606254866",
"telephone_number": "312-505-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 W BELMONT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606570939",
"telephone_number": "773-799-8966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRACCARO",
"first_name": "JOSH",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-11",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "150105143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.