Individual provider Active NPI

Jill Ann Bajorek, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1174862619
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015646 Issued in IL
Practice address
3656 N Halsted St
Ste a
Chicago, IL 60613-5974
Phone
(773) 472-6643
NPI assigned
Feb 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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 149.015646 IL Primary

Addresses

Primary practice location

3656 N Halsted St
Ste a
Chicago, IL 60613-5974

Mailing address

620 W Addison St
206
Chicago, IL 60613-4402
Phone (708) 927-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 22, 2023 through Sep 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015646ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Aspen Center for Counseling and Consultation, LLC Clinical Past Accepting new patients

Organizations & group practices 1

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": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1174862619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W ADDISON ST",
            "address_2": "206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134402",
            "telephone_number": "708-927-8881",
            "fax_number": "708-763-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "address_2": "STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135974",
            "telephone_number": "773-472-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJOREK",
        "first_name": "JILL",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.