Individual provider Active NPI

Sandra Rincon, LCSW

  • Clinical Social Worker
  • Aurora, IL
National Provider Identifier
1235823428
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149026331 Issued in IL
Practice address
2124 Ogden Ave Ste 301
Aurora, IL 60504-7542
Phone
(630) 428-7890
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 149026331 IL Primary

Addresses

Primary practice location

2124 Ogden Ave Ste 301
Aurora, IL 60504-7542

Mailing address

2124 Ogden Ave Ste 301
Aurora, IL 60504-7542

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
I20240401002475 IL Practitioner - Clinical Social Worker 7416395157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

2124 Ogden Ave
Suite 301
Aurora, IL 60504-7542
Phone (630) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149026331ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Apr 1, 2024 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients
Edgewood Clinical Services, P.C. Past Accepting new patients

Locations

2124 Ogden Ave
Ste 301
Aurora, IL 60504
Phone (331) 227-5496

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

3027 English Rows Ave
Ste 201
Naperville, IL 60564

Organizations & group practices 3

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": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1235823428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 OGDEN AVE STE 301",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 OGDEN AVE STE 301",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047542",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINCON",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149026331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.