Jasmine Bailey

Individual provider Active NPI Clinical Social Worker · Hines, IL

NPI 1194454694 · NPPES record last updated Aug 22, 2025

Key facts

NPI
1194454694
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.026834 (IL)
Practice address
5000 S 5TH Ave
Hines, IL 60141-3030
Phone
(708) 202-2511
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.026834ILMDClinical Social Worker
35177MNMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 35177 MN
Clinical Social Worker 1041C0700X 149.026834 IL Yes

Addresses

Primary practice location

5000 S 5TH Ave
Hines, IL 60141-3030

Mailing address

5000 S 5TH Ave
Hines, IL 60141-3030

Other identifiers

IdentifierTypeStateIssuer
150.107900OtherILDEPARTMENT OF VETERAN AFFAIRS

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Office Direct

Other providers in Hines, IL

All providers in Hines, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.