Individual provider Active NPI

Stephanie Kujawa, LCSW

  • Clinical Social Worker
  • Oak Brook, IL
National Provider Identifier
1245722008
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020347 Issued in IL
Practice address
2625 Butterfield Rd
Oak Brook, IL 60523-1234
Phone
(847) 338-6101
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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 149.020347 IL Primary

Addresses

Primary practice location

2625 Butterfield Rd
Oak Brook, IL 60523-1234

Mailing address

1400 N Elmhurst Rd Apt 308
Mount Prospect, IL 60056-1054
Phone (847) 344-8047

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
I20220104000513 IL Practitioner - Clinical Social Worker 6406247378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mulso Associates Counseling LTDGroup PAC ID 7517320138, 3 clinicians

Practice addresses (Care Compare)

2625 Butterfield Rd
Suite 138S
Oak Brook, IL 60523-1244
Phone (847) 344-8047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.020347ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mulso Associates Counseling, LTD CurrentSince Jul 23, 2023 Accepting new patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Dec 23, 2021 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

2625 Butterfield Rd
Oak Brook, IL 60523
Phone (630) 528-3835

2625 Butterfield Rd
Ste 138S
Oak Brook, IL 60523
Phone (630) 290-2246

Organizations & group practices 2

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": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1245722008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N ELMHURST RD APT 308",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561054",
            "telephone_number": "847-344-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "847-338-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJAWA",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.