Individual provider Active NPI

Ana Fajardo, LCSW

  • Clinical Social Worker
  • Bolingbrook, IL
National Provider Identifier
1184269029
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149025776 Issued in IL
Practice address
440 W Boughton Rd Ste 104
Bolingbrook, IL 60440-1406
Phone
(815) 295-5470
NPI assigned
Nov 14, 2019
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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 149025776 IL Primary

Addresses

Primary practice location

440 W Boughton Rd Ste 104
Bolingbrook, IL 60440-1406

Mailing address

619 Belmont Ave
Oswego, IL 60543-7729
Phone (815) 216-7016

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
I20240514002431 IL Practitioner - Clinical Social Worker 8123469723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essentially You Counseling and Wellness Services, LLCGroup PAC ID 5294110516, 4 clinicians

Practice addresses (Care Compare)

440 W Boughton Rd
Suite 104
Bolingbrook, IL 60440-1406
Phone (815) 295-5470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149025776ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Essentially You Counseling and Wellness Services, LLC CurrentSince Apr 24, 2024 Accepting new patients

Locations

125 Fairfield Way
Ste 380
Bloomingdale, IL 60108
Phone (815) 219-3193

255 E Lake St
Ste 200
Bloomingdale, IL 60108
Phone (815) 295-5470

440 W Boughton Rd
Ste 104
Bolingbrook, IL 60440
Phone (331) 318-8181

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1184269029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 BELMONT AVE",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437729",
            "telephone_number": "815-216-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W BOUGHTON RD STE 104",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401406",
            "telephone_number": "815-295-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "ANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.