Individual provider Active NPI

Marc Smith

  • Clinical Social Worker
  • Joliet, IL
National Provider Identifier
1275391617
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010592 Issued in IL
Practice address
1051 Essington Rd Ste 280
Joliet, IL 60435-2808
Phone
(855) 284-7483
NPI assigned
Mar 11, 2024
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 149010592 IL Primary

Addresses

Primary practice location

1051 Essington Rd Ste 280
Joliet, IL 60435-2808

Mailing address

PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483

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
I20240425002975 IL Practitioner - Clinical Social Worker 7214377159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

1051 Essington Rd
Suite 280
Joliet, IL 60435-2808
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010592ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Illinois CurrentSince Mar 20, 2024 Accepting new patients

Locations

333 N Michigan Ave
Ste 1810
Chicago, IL 60601
Phone (217) 850-1133

1051 Essington Rd
Ste 280
Joliet, IL 60435
Phone (217) 850-1133

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": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1275391617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 ESSINGTON RD STE 280",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352808",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.