Individual provider Active NPI

Jennifer Zeck, LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1154845089
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019452 Issued in IL
Practice address
900 Main St Ste 400
Peoria, IL 61602-1060
Phone
(309) 672-3100
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 149019452 IL Primary

Addresses

Primary practice location

900 Main St Ste 400
Peoria, IL 61602-1060

Mailing address

900 Main St Ste 400
Peoria, IL 61602-1060
Phone (309) 672-3100

Other identifiers 1

IdentifierTypeStateIssuer
149019452OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20170919002217 IL Practitioner - Clinical Social Worker 1456625144 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Clinical CurrentSince Nov 19, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2017 Accepting new patients
Proctor Health Systems CurrentSince Sep 1, 2017 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 1, 2017 Accepting new patients
Proctor Health Systems CurrentSince Sep 1, 2017 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Illuminated Wellness Clinical CurrentSince Dec 28, 2022 Accepting new patients

Locations

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A1
Peoria, IL 61602

900 Main St
Ste 400
Peoria, IL 61602
Phone (309) 671-3100

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

100 Hillcrest Dr
Ste E
Washington, IL 61571
Phone (248) 515-4735

100 Hillcrest Dr
Ste C
Washington, IL 61571
Phone (309) 444-2800

Organizations & group practices 7

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154845089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 400",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021060",
            "telephone_number": "309-672-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 400",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021060",
            "telephone_number": "309-672-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZECK",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "149019452",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.