Individual provider Active NPI

Elizabeth Jill Burke

  • Clinical Social Worker
  • Park Ridge, IL
National Provider Identifier
1235445693
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149016042 Issued in IL
Practice address
1580 N Northwest Hwy
Suite 224
Park Ridge, IL 60068-1444
Phone
(847) 562-6376
NPI assigned
Aug 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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 149016042 IL Primary

Addresses

Primary practice location

1580 N Northwest Hwy
Suite 224
Park Ridge, IL 60068-1444

Mailing address

1580 N Northwest Hwy
Suite 224
Park Ridge, IL 60068-1444
Phone (847) 562-6376

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
149016042ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1235445693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY",
            "address_2": "SUITE 224",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681444",
            "telephone_number": "847-562-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY",
            "address_2": "SUITE 224",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681444",
            "telephone_number": "847-562-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "ELIZABETH",
        "middle_name": "JILL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.