Individual provider Active NPI

Hafsa Ahsan

  • Clinical Social Worker
  • Berwyn, IL
National Provider Identifier
1124732979
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.028573 Issued in IL
Practice address
3245 Grove Ave Ste 107
Berwyn, IL 60402-3475
Phone
(847) 920-7551
NPI assigned
Jan 6, 2023
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 149.028573 IL Primary

Addresses

Primary practice location

3245 Grove Ave Ste 107
Berwyn, IL 60402-3475

Mailing address

2501 Chatham Rd Ste N
Springfield, IL 62704-4188
Phone (847) 993-1589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.028573ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Noor Wilderness Healing PLLC Clinical Current Accepting new patients

Locations

2501 Chatham Rd
Ste N
Springfield, IL 62704
Phone (773) 250-7404

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1124732979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE N",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "847-993-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE STE 107",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023475",
            "telephone_number": "847-920-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHSAN",
        "first_name": "HAFSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.