Individual provider Active NPI

Amy Riehle, LCSW

  • Clinical Social Worker
  • Freeport, IL
National Provider Identifier
1174537377
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009805 Issued in IL
Practice address
1120 S Park Blvd
Freeport, IL 61032-4619
Phone
(815) 235-0009
Fax
(815) 801-7665
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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 149009805 IL Primary

Addresses

Primary practice location

1120 S Park Blvd
Freeport, IL 61032-4619

Mailing address

1315 W Demeter Dr
Freeport, IL 61032-6607
Phone (815) 235-0009

Other identifiers 1

IdentifierTypeStateIssuer
8932016OtherILBLUE SHIELD PROVIDER #

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
I20150116001333 IL Practitioner - Clinical Social Worker 0446574644 Practice locations: Freeport, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1120 S Park Blvd
Freeport, IL 61032-4619
Phone (815) 235-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1174537377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W DEMETER DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326607",
            "telephone_number": "815-235-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S PARK BLVD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324619",
            "telephone_number": "815-235-0009",
            "fax_number": "815-801-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEHLE",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "8932016",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.