Vincent James Henneburg

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

120 S Marion St
Oak Park, IL 60302-2809

Phone

(708) 383-7500

NPI assigned

Nov 20, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Conscious Reset Therapy and Wellness, PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1609745470
  NPD Authorized official

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1245744754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 W GRENSHAW ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124123",
            "telephone_number": "703-405-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEBURG",
        "first_name": "VINCENT",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Rae Hemker, M.S.W., LCSW
• Christin Hemmens, P.T.
• Ericka Henderson
• Whitney Adrienne Henderson, FNP-BC
• Austin Henke
• Lauren Gail Henry, LCPC
• Evan Henschel, MSW, LSW
• Amanda Hensley
• Hephzibah Children'S Association
• Hephzibah Children'S Association

• Social Worker in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.