Individual provider Active NPI

Danielle Ann Czajkowski, LCSW

  • Clinical Social Worker
  • Morris, IL
National Provider Identifier
1265125611
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024995 Issued in IL
Practice address
1095 Twilight Dr
Morris, IL 60450-3305
Phone
(815) 942-5108
NPI assigned
May 31, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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 149.024995 IL Primary

Addresses

Primary practice location

1095 Twilight Dr
Morris, IL 60450-3305

Mailing address

26446 W Wild Rose Dr
Channahon, IL 60410-3382
Phone (708) 310-5535

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
I20230617000242 IL Practitioner - Clinical Social Worker 8325406689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
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)

1095 Twilight Dr
Morris, IL 60450-3305
Phone (815) 942-5108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024995ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince May 7, 2023 Accepting new patients

Locations

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

1095 Twilight Dr
Morris, IL 60450
Phone (312) 225-2444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1265125611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26446 W WILD ROSE DR",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604103382",
            "telephone_number": "708-310-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 TWILIGHT DR",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503305",
            "telephone_number": "815-942-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAJKOWSKI",
        "first_name": "DANIELLE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

Verify at the official NPI Registry.