Individual provider Active NPI

Djuan Powell

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1255907671
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5110 S Kenwood Ave Apt 310
Chicago, IL 60615-4045
Phone
(773) 592-4243
NPI assigned
May 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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 Primary

Addresses

Primary practice location

5110 S Kenwood Ave Apt 310
Chicago, IL 60615-4045

Mailing address

5110 S Kenwood Ave Apt 310
Chicago, IL 60615-4045

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
I20210617000141 IL Practitioner - Clinical Social Worker 2466852124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

10300 Southwest Hwy
Chicago Ridge, IL 60415-1426
Phone (708) 425-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Mar 27, 2023 Accepting new patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince May 1, 2021 Accepting new patients

Locations

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

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

10300 Southwest Hwy
Chicago Ridge, IL 60415
Phone (708) 425-1100

3450 Oakton St
Ste 300
Skokie, IL 60076

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1255907671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 S KENWOOD AVE APT 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 S KENWOOD AVE APT 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154045",
            "telephone_number": "773-592-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DJUAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.