Individual provider Active NPI

Benjamin Walker, LSCW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1194183228
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017926 Issued in IL
Practice address
3656 N Halsted St
Chicago, IL 60613-5974
Phone
(773) 472-6469
NPI assigned
Feb 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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 149.017926 IL Primary

Addresses

Primary practice location

3656 N Halsted St
Chicago, IL 60613-5974

Mailing address

4877 N Kenmore Ave Apt 3
Chicago, IL 60640-3742
Phone (630) 674-2504

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
I20191122000150 IL Practitioner - Clinical Social Worker 7911339411 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mirjam Quinn and Associates LTDGroup PAC ID 7517315914, 4 clinicians

Practice addresses (Care Compare)

10801 S Western Ave
Suite 2B
Chicago, IL 60643-3225
Phone (708) 586-7357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017926ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysanthemum Counseling, LTD Clinical CurrentSince Oct 25, 2019 Accepting new patients
Valentin Berman MD PC CurrentSince Aug 5, 2024 Accepting new patients
Mirjam Quinn and Associates, LTD CurrentSince Aug 5, 2024 Accepting new patients

Locations

10801 S Western Ave
Ste 2B
Chicago, IL 60643
Phone (708) 499-3525

10725 S Western Ave
Chicago, IL 60643
Phone (773) 233-6500

Organizations & group practices 3

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": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1194183228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4877 N KENMORE AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403742",
            "telephone_number": "630-674-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135974",
            "telephone_number": "773-472-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "LSCW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.