Active NPI
Elvedina Owen, LCSW
- Clinical Social Worker
- Oak Brook, IL
National Provider Identifier
1235582685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149018342
- Practice address
- 900 Jorie Blvd Ste 11
Oak Brook, IL 60523-2268 - Phone
- (708) 990-8221
- Fax
- (708) 416-8800
- NPI assigned
- Jul 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149018342 | IL | Primary |
Addresses
Primary practice location
900 Jorie Blvd Ste 11
Oak Brook, IL 60523-2268
Mailing address
343 Lionel Rd
Riverside, IL 60546-2205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235582685 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
900 Jorie Blvd
Suite 11
Oak Brook, IL 60523-2268
Phone (708) 990-8221
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychealth Services, Inc. | Clinical | Current | Accepting new patients |
Locations
900 Jorie Blvd
Ste 11
Oak Brook, IL 60523
Phone (708) 990-8221
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.
-
- Clinical Social Worker
- Oak Brook, IL
- NPI 1275005670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1235582685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 LIONEL RD",
"city": "RIVERSIDE",
"state": "IL",
"postal_code": "605462205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 JORIE BLVD STE 11",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232268",
"telephone_number": "708-990-8221",
"fax_number": "708-416-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWEN",
"first_name": "ELVEDINA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149018342",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235582685",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.