Tami S Broskow, LCSW, PEL:SSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014493 Issued in IL

Practice address

453 Coventry LN Ste 103
Crystal Lake, IL 60014-7504

Phone

(815) 219-4977

Fax

(779) 994-4929

NPI assigned

Mar 20, 2025

Last updated

Nov 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1184425688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 COVENTRY LN STE 103",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147504",
            "telephone_number": "815-219-4977",
            "fax_number": "779-994-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 COVENTRY LN STE 103",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147504",
            "telephone_number": "815-219-4977",
            "fax_number": "779-994-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSKOW",
        "first_name": "TAMI",
        "middle_name": "S",
        "credential": "LCSW, PEL:SSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Brizzolara, M.D.
• Aphinya Brock, PHARM.D.
• Lorin Gene Brody, FNP-BC
• David S Bromet, MD
• Alma Brooks
• Cheryl R Brown-Cook, DPM
• Christina Brown
• Clara Louise Brown, LCSW
• Kevin M Bruggeman, DDS
• Paul A Bruggeman, DDS

• Clinical Social Worker in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.