Individual provider Active NPI

John C Reifenstuhl, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1174636211
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007291 Issued in IL
Practice address
800 W Fifth Ave
Ste 101a
Naperville, IL 60563
Phone
(630) 778-6159
Fax
(360) 357-3093
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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 149007291 IL Primary

Addresses

Primary practice location

800 W Fifth Ave
Ste 101a
Naperville, IL 60563

Mailing address

PO Box 5970
Villa Park, IL 60181-5312
Phone (630) 424-9482

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
I20070412000043 IL Practitioner - Clinical Social Worker 0143325670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakbrook Behavioral Health LTDGroup PAC ID 5496740789, 6 clinicians

Practice addresses (Care Compare)

2803 Butterfield Rd
Suite 200
Oak Brook, IL 60523-1165
Phone (630) 424-9204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oakbrook Behavioral Health LTD CurrentSince Aug 1, 2012 Accepting new patients
Khadija Khan MDSC CurrentSince Jun 12, 2022 Accepting new patients

Locations

1401 Branding Ave
Ste 312
Downers Grove, IL 60515
Phone (630) 424-9204

2803 Butterfield Rd
Ste 200
Oak Brook, IL 60523
Phone (630) 424-0652

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1174636211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5970",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601815312",
            "telephone_number": "630-424-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W FIFTH AVE",
            "address_2": "STE 101A",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "630-778-6159",
            "fax_number": "360-357-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIFENSTUHL",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.