Individual provider Active NPI

Tammy Hildebrand, LCSW

  • Clinical Social Worker
  • Warrenville, IL
National Provider Identifier
1144389693
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009104 Issued in IL
Practice address
27475 Ferry Rd Ste 105
Warrenville, IL 60555-3808
Phone
(630) 699-7254
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 149009104 IL Primary

Addresses

Primary practice location

27475 Ferry Rd Ste 105
Warrenville, IL 60555-3808

Mailing address

27475 Ferry Rd Ste 105
Warrenville, IL 60555-3808
Phone (630) 699-7254

Other names 1

  • Tammy Hildebrand Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210827000059 IL Practitioner - Clinical Social Worker 2668877705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Washington University School of Medicine, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

27475 Ferry Rd
Suite 105
Warrenville, IL 60555-3808
Phone (630) 699-7254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149009104ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Holistic Counseling Clinical CurrentSince Jul 13, 2021 Accepting new patients

Locations

387 Shuman Blvd
Ste 325W
Naperville, IL 60563

1770 Park St
Ste 107
Naperville, IL 60563
Phone (630) 355-7055

27475 Ferry Rd
Ste 105
Warrenville, IL 60555
Phone (630) 520-2641

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1144389693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27475 FERRY RD STE 105",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553808",
            "telephone_number": "630-699-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27475 FERRY RD STE 105",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553808",
            "telephone_number": "630-699-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "TAMMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "HILDEBRAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.