Individual provider Active NPI

Jared Elwart, LCSW

  • Social Worker
  • Downers Grove, IL
National Provider Identifier
1164193876
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
149.025584 Issued in IL
Practice address
1125 Franklin St
Downers Grove, IL 60515-3551
Phone
(630) 437-1999
NPI assigned
Sep 22, 2021
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 149.025584 IL Primary

Addresses

Primary practice location

1125 Franklin St
Downers Grove, IL 60515-3551

Mailing address

106 S Lincolnway Ste F
North Aurora, IL 60542-1597
Phone (630) 801-1669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.025584ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interlude Wellness PLLC CurrentSince May 12, 2024 Accepting new patients

Locations

1125 Franklin St
Downers Grove, IL 60515
Phone (630) 247-1978

1125 Franklin St
Ste 128
Downers Grove, IL 60515

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1164193876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S LINCOLNWAY STE F",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421597",
            "telephone_number": "630-801-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 FRANKLIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153551",
            "telephone_number": "630-437-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELWART",
        "first_name": "JARED",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.025584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.