Individual provider Active NPI

Lillie Prince, LCSW

  • Clinical Social Worker
  • North Chicago, IL
National Provider Identifier
1134590284
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017901 Issued in IL
Practice address
3001 Greenbay Road
North Chicago, IL 60064
Phone
(224) 610-1148
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 149.017901 IL Primary

Addresses

Primary practice location

3001 Greenbay Road
North Chicago, IL 60064

Mailing address

3909 Midway Dr
Island Lake, IL 60042-9638
Phone (312) 982-3778

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
149.017901ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1134590284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 MIDWAY DR",
            "city": "ISLAND LAKE",
            "state": "IL",
            "postal_code": "600429638",
            "telephone_number": "312-982-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREENBAY ROAD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "60064",
            "telephone_number": "224-610-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "LILLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.