Individual provider Active NPI

Christian Zamarriego, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1215822010
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027731 Issued in IL
Practice address
3640 W Polk St Apt 1
Chicago, IL 60624-4049
Phone
(530) 300-6427
NPI assigned
Jun 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 149.027731 IL Primary

Addresses

Primary practice location

3640 W Polk St Apt 1
Chicago, IL 60624-4049

Mailing address

3640 W Polk St Apt 1
Chicago, IL 60624-4049

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
I20251103003586 IL Practitioner - Clinical Social Worker 9739679374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Moon Senior Counseling of Illinois LLCGroup PAC ID 7012172893, 30 clinicians

Practice addresses (Care Compare)

10204 Bode St
Suite C
Plainfield, IL 60585-9813
Phone (630) 896-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.027731ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Aug 23, 2025 Accepting new patients

Locations

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

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": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1215822010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 W POLK ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 W POLK ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244049",
            "telephone_number": "530-300-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMARRIEGO",
        "first_name": "CHRISTIAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.