Individual provider Active NPI

Victoria M. Hominick, LCSW

  • Clinical Social Worker
  • Loves Park, IL
National Provider Identifier
1184775207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
7124 Windsor Lake Pkwy
Suite 17
Loves Park, IL 61111-3800
Phone
(815) 282-1807
Fax
(815) 282-1003
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

7124 Windsor Lake Pkwy
Suite 17
Loves Park, IL 61111-3800

Mailing address

7124 Windsor Lake Pkwy
Suite 17
Loves Park, IL 61111-3800
Phone (815) 282-1807

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
I20190207000021 IL Practitioner - Clinical Social Worker 1658619218 Practice locations: Rockford, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5758 Elaine Dr
Suite 103
Rockford, IL 61108-3102
Phone (815) 985-9885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149004399ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184775207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 WINDSOR LAKE PKWY",
            "address_2": "SUITE 17",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113800",
            "telephone_number": "815-282-1807",
            "fax_number": "815-282-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7124 WINDSOR LAKE PKWY",
            "address_2": "SUITE 17",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113800",
            "telephone_number": "815-282-1807",
            "fax_number": "815-282-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMINICK",
        "first_name": "VICTORIA",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

Verify at the official NPI Registry.