Individual provider Active NPI

Teresa Elvira Mendoza, LCSW, MSW

  • Clinical Social Worker
  • Wheaton, IL
National Provider Identifier
1265106801
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027128 Issued in IL
Practice address
222 E Willow Ave
Wheaton, IL 60187-5426
Phone
(630) 784-4805
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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 149027128 IL Primary

Addresses

Primary practice location

222 E Willow Ave
Wheaton, IL 60187-5426

Mailing address

222 E Willow Ave
Wheaton, IL 60187-5426

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
I20240604001577 IL Practitioner - Clinical Social Worker 0244772408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kenneth Young CenterGroup PAC ID 7416940655, 23 clinicians

Practice addresses (Care Compare)

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone (847) 524-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Young Center CurrentSince May 1, 2024 Accepting new patients

Locations

1001 Rohlwing Rd
Elk Grove Vlg, IL 60007

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.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1265106801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E WILLOW AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E WILLOW AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875426",
            "telephone_number": "630-784-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "TERESA",
        "middle_name": "ELVIRA",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.