Individual provider Active NPI

Diane R Funk, LCSW

  • Clinical Social Worker
  • Ottawa, IL
National Provider Identifier
1184771420
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.006277 Issued in IL
Practice address
227 W Madison St
Ottawa, IL 61350-2866
Phone
(815) 942-6323
Fax
(779) 210-5541
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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 149.006277 IL Primary

Addresses

Primary practice location

227 W Madison St
Ottawa, IL 61350-2866

Mailing address

PO Box 713260
Chicago, IL 60677-0264
Phone (630) 545-6016

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfunk201533@direct.edward.org

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
I20080114000378 IL Practitioner - Clinical Social Worker 0143301325 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.006277ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Illinois Medical PC CurrentSince Oct 27, 2025 Accepting new patients
Premise Health of Illinois Medical PC Current Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 1, 2022 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 1, 2022 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

16906 Collection Ctr Dr
Chicago, IL 60693

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

6150 Joliet Rd
Countryside, IL 60525
Phone (708) 485-2273

1401 Lakewood Dr
Ste A
Morris, IL 60450

227 W Madison St
Ottawa, IL 61350

227 W Madison St
Fl 2
Ottawa, IL 61350

Organizations & group practices 4

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1184771420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770264",
            "telephone_number": "630-545-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W MADISON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502866",
            "telephone_number": "815-942-6323",
            "fax_number": "779-210-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "DIANE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.006277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfunk201533@direct.edward.org",
            "affiliation": "N",
            "address_1": "227 W Madison St Fl 2",
            "city": "Ottawa",
            "state": "IL",
            "country_code": "US",
            "postal_code": "613502866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.