Individual provider Active NPI

Elizabeth Vogt, LCSW, CADC

  • Clinical Social Worker
  • Antioch, IL
National Provider Identifier
1134587744
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022522 Issued in IL
Practice address
41819 N Circle Dr
Antioch, IL 60002-7307
Phone
(847) 313-1435
NPI assigned
Feb 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9494123 WI
Clinical Social Worker 1041C0700X 149.022522 IL Primary

Addresses

Primary practice location

41819 N Circle Dr
Antioch, IL 60002-7307

Mailing address

41819 N Circle Dr
Antioch, IL 60002-7307
Phone (847) 313-1435

Other practice location 1

197 W Chestnut St
Burlington, WI 53105-1200
Phone (262) 763-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220331001494 IL Practitioner - Clinical Social Worker 0143616185 Reassigns benefits to 1 organization
I20220408002260 WI Practitioner - Clinical Social Worker 0143616185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

41819 N Circle Dr
Antioch, IL 60002-7307
Phone (847) 313-1435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9494123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychology Associates, LLC CurrentSince Mar 30, 2022 Accepting new patients
Ev Psychotherapy PLLC CurrentSince Dec 1, 2021 Accepting new patients
Odyssey Healthcare Operating B, LP PastSince Mar 30, 2022 Accepting new patients

Locations

935 Skidmore Dr
Antioch, IL 60002
Phone (847) 313-1435

197 W Chestnut St
Ste 100
Burlington, WI 53105
Phone (262) 763-9191

Organizations & group practices 3

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1134587744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41819 N CIRCLE DR",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600027307",
            "telephone_number": "847-313-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41819 N CIRCLE DR",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600027307",
            "telephone_number": "847-313-1435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 W Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "WI",
            "postal_code": "531051200",
            "country_code": "US",
            "telephone_number": "262-763-9191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGT",
        "first_name": "ELIZABETH",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9494123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.