Individual provider Active NPI

Adam Apostolovich, L.C.S.W.

  • Clinical Social Worker
  • Elmhurst, IL
National Provider Identifier
1215473285
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018975 Issued in IL
Practice address
163 E Jackson St
Elmhurst, IL 60126-5145
Phone
(773) 315-2810
NPI assigned
Jan 13, 2017
Last updated
Jan 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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 149.018975 IL Primary

Addresses

Primary practice location

163 E Jackson St
Elmhurst, IL 60126-5145

Mailing address

163 E Jackson St
Elmhurst, IL 60126-5145
Phone (773) 315-2810

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
I20170119002627 IL Practitioner - Clinical Social Worker 0547542961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

163 E Jackson St
Elmhurst, IL 60126-5145
Phone (773) 315-2810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.018975ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Stages Therapeutic Services LLC Clinical CurrentSince Jul 24, 2018 Accepting new patients
Cognitive Care Counseling, PLLC Clinical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1215473285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 E JACKSON ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265145",
            "telephone_number": "773-315-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 E JACKSON ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265145",
            "telephone_number": "773-315-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APOSTOLOVICH",
        "first_name": "ADAM",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-13",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.