Individual provider Active NPI

Jacqueline Sonnenberg Mallinger, MSW

  • Clinical Social Worker
  • Buffalo Grove, IL
National Provider Identifier
1164598660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
355 West Dundee
Suite 209
Buffalo Grove, IL 60089
Phone
(847) 821-0957
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

355 West Dundee
Suite 209
Buffalo Grove, IL 60089

Mailing address

1183 Gail Drive
Buffalo Grove, IL 60089
Phone (847) 821-0957

Other identifiers 1

IdentifierTypeStateIssuer
1605848OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Jacqueline Emily Sonnenberg Other 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
I20100614000765 IL Practitioner - Clinical Social Worker 3779613914 Practice locations: Northbrook, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3330 Dundee Rd
N3
Northbrook, IL 60062-2329
Phone (847) 821-0957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149 000794ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164598660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 GAIL DRIVE",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "60089",
            "telephone_number": "847-821-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 WEST DUNDEE",
            "address_2": "SUITE 209",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "60089",
            "telephone_number": "847-821-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLINGER",
        "first_name": "JACQUELINE",
        "middle_name": "SONNENBERG",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1605848",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "SONNENBERG",
            "middle_name": "EMILY",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.