Active NPI
Vanessa Marie Peters, APSW
- Social Worker
- North Chicago, IL
National Provider Identifier
1144845850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 131639-121
- Practice address
- 3001 Green Bay Rd
North Chicago, IL 60064-3048 - Phone
- (224) 610-1261
- Fax
- (224) 610-2958
- NPI assigned
- Jun 9, 2020
- Sex
- Female
- 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 | 131639-121 | WI | Primary |
Addresses
Primary practice location
3001 Green Bay Rd
North Chicago, IL 60064-3048
Mailing address
7613 70TH Ave Apt 9
Kenosha, WI 53142-4021
Phone (262) 331-1281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 131639-121 | Other | WI | WISCONSIN STATE LICENSING |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 131639-121 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1144845850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7613 70TH AVE APT 9",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531424021",
"telephone_number": "262-331-1281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 GREEN BAY RD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643048",
"telephone_number": "224-610-1261",
"fax_number": "224-610-2958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "VANESSA",
"middle_name": "MARIE",
"credential": "APSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "131639-121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN STATE LICENSING",
"identifier": "131639-121",
"state": "WI"
}
],
"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 Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.