Individual provider Active NPI

Aisha A Shannon, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1194249896
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019604 Issued in IL
Practice address
8946 S Marshfield Ave
Chicago, IL 60620-4954
Phone
(773) 818-0900
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 149019604 IL Primary

Addresses

Primary practice location

8946 S Marshfield Ave
Chicago, IL 60620-4954

Mailing address

8946 S Marshfield Ave
Chicago, IL 60620-4954
Phone (773) 818-0900

Other practice location 1

1 Westbrook Corporate Ctr Ste 300
Westchester, IL 60154-5709
Phone (866) 949-0108

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
I20260624004662 IL Practitioner - Clinical Social Worker 4284107848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21305 Gray Hawk Dr
Matteson, IL 60443-3345

52013 Beech Dr
Chesterfield, MI 48047-4558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149019604ILMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194249896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8946 S MARSHFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606204954",
            "telephone_number": "773-818-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8946 S MARSHFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606204954",
            "telephone_number": "773-818-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Westbrook Corporate Ctr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Westchester",
            "state": "IL",
            "postal_code": "601545709",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "AISHA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.