Individual provider Active NPI

Sharonslaba Davila, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1205205028
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017681 Issued in IL
Practice address
4043 N Drake Ave
Chicago, IL 60618-2219
Phone
(773) 681-0049
NPI assigned
Sep 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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 149017681 IL Primary

Addresses

Primary practice location

4043 N Drake Ave
Chicago, IL 60618-2219

Mailing address

4043 N Drake Ave
Chicago, IL 60618-2219
Phone (773) 681-0049

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
I20170419001413 IL Practitioner - Clinical Social Worker 7810273273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Eaves Health Partners PLLCGroup PAC ID 2466844220, 19 clinicians

Practice addresses (Care Compare)

5151 Church St
Skokie, IL 60077-1123
Phone (773) 436-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149017681ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eaves Health Partners PLLC Clinical CurrentSince Feb 14, 2024 Accepting new patients
Tapestry 360 Health Past Accepting new patients

Locations

5151 Church St
Skokie, IL 60077
Phone (773) 436-6600

Interoperability endpoints

  • Direct secure messaging: sharonslaba.davila.1@27315.direct.athenahealth.com

Organizations & group practices 2

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": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1205205028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 N DRAKE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182219",
            "telephone_number": "773-681-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 N DRAKE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182219",
            "telephone_number": "773-681-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "SHARONSLABA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.