NPIMap

Organization Active NPI

Muddworks, Inc.

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1174659924
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MUDDWORKS, INC.
Practice address
708 Church St
Suite 258
Evanston, IL 60201-3875
Phone
(847) 332-2589
Fax
(847) 332-2609
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Peter Michael Mudd
Title
President
Phone
(847) 332-2589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X IL Primary

Addresses

Primary practice location

708 Church St
Suite 258
Evanston, IL 60201-3875

Mailing address

708 Church St
Suite 258
Evanston, IL 60201-3875
Phone (847) 332-2589

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174659924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST",
            "address_2": "SUITE 258",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013875",
            "telephone_number": "847-332-2589",
            "fax_number": "847-332-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST",
            "address_2": "SUITE 258",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013875",
            "telephone_number": "847-332-2589",
            "fax_number": "847-332-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUDDWORKS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUDD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-332-2589"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.