NPIMap

Individual provider Active NPI

Kelly Jones

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1134527856
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012328 Issued in IL
Practice address
4750 N Sheridan Rd
Suite 500
Chicago, IL 60640-7528
Phone
(773) 751-4186
Fax
(773) 751-4174
NPI assigned
Dec 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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 149.012328 IL Primary

Addresses

Primary practice location

4750 N Sheridan Rd
Suite 500
Chicago, IL 60640-7528

Mailing address

4750 N Sheridan Rd
Suite 500
Chicago, IL 60640-7528

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012328ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Alliance Health Past Accepting new patients
Heartland Alliance Health Past Accepting new patients

Organizations & group practices 2

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": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1134527856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N SHERIDAN RD",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N SHERIDAN RD",
            "address_2": "SUITE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407528",
            "telephone_number": "773-751-4186",
            "fax_number": "773-751-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012328",
            "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 Dec 11, 2014; 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.