Individual provider Active NPI

Tommie D Dewese, LCSW,ACSW

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1235224726
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149001047 Issued in IL
Practice address
1120 Randall Court
Geneva, IL 60134
Phone
(630) 232-1070
Fax
(630) 232-1471
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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 149001047 IL Primary

Addresses

Primary practice location

1120 Randall Court
Geneva, IL 60134

Mailing address

611 N. Stone
La Grange Park, IL 60526
Phone (708) 352-2079

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149001047ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1235224726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N. STONE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "60526",
            "telephone_number": "708-352-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 RANDALL COURT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-232-1070",
            "fax_number": "630-232-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWESE",
        "first_name": "TOMMIE",
        "middle_name": "D",
        "credential": "LCSW,ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149001047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.