Active NPI
Charles Alvin Phillips Jr.
- Social Worker
- Chicago, IL
National Provider Identifier
1124953476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.118110
- Practice address
- 259 E 115TH St
Chicago, IL 60628-5014 - Phone
- (773) 339-7394
- Fax
- (773) 339-7394
- NPI assigned
- Jun 17, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.118110 | IL | Primary |
Addresses
Primary practice location
259 E 115TH St
Chicago, IL 60628-5014
Mailing address
259 E 115TH St
Chicago, IL 60628-5014
Phone (773) 981-7816
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1124953476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E 115TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606285014",
"telephone_number": "773-981-7816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E 115TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606285014",
"telephone_number": "773-339-7394",
"fax_number": "773-339-7394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CHARLES",
"middle_name": "ALVIN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-17",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "IL",
"license": "150.118110",
"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 Jun 17, 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.