Individual provider Active NPI

Angela Marie Rush, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1215098959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
E 65TH Street at Lake Michigan
Chicago, IL 60649
Phone
(773) 256-6738
Fax
(773) 363-7664
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

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

E 65TH Street at Lake Michigan
Chicago, IL 60649

Mailing address

1510 N Wieland St
Third Floor
Chicago, IL 60610-3428
Phone (773) 256-5738

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149009388ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215098959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N WIELAND ST",
            "address_2": "THIRD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103428",
            "telephone_number": "773-256-5738",
            "fax_number": "773-363-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E 65TH STREET AT LAKE MICHIGAN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-256-6738",
            "fax_number": "773-363-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "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 Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.