Individual provider Active NPI

Jill Pixley, L.C.S.W

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1225304694
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015102 Issued in IL
Practice address
390 Congress Parkway
Suite J
Crystal Lake, IL 60014
Phone
(815) 356-5050
Fax
(815) 356-5094
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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 149015102 IL Primary

Addresses

Primary practice location

390 Congress Parkway
Suite J
Crystal Lake, IL 60014

Mailing address

1701 E Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211

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
I20121217000068 IL Practitioner - Clinical Social Worker 2062664246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pra Behavioral LLCGroup PAC ID 3274427729, 24 clinicians

Practice addresses (Care Compare)

1701 E Woodfield Rd
Suite 1000
Schaumburg, IL 60173-5113
Phone (847) 240-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015102ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pra Behavioral LLC Clinical CurrentSince Sep 24, 2012 Accepting new patients

Locations

1701 E Woodfield Rd
Ste 1000
Schaumburg, IL 60173
Phone (847) 240-2211

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1225304694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E WOODFIELD ROAD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735113",
            "telephone_number": "847-240-2211",
            "fax_number": "847-240-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 CONGRESS PARKWAY",
            "address_2": "SUITE J",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-356-5050",
            "fax_number": "815-356-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIXLEY",
        "first_name": "JILL",
        "credential": "L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.