Augustus C Edeh, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015078 Issued in IL

Practice address

5658 S Kolin Ave Unit 2
Chicago, IL 60629-4839

Phone

(773) 412-7420

Fax

(773) 306-2675

NPI assigned

Feb 24, 2012

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicago Area Behavioral Health Services IncGroup PAC ID 4789977216, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Chicago Area Behavioral Health Services Inc

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1518318666
  Medicare reassignment Care Compare group NPD Authorized official
• Home Psych Services, P.C.

  • Clinical Psychologist
  • Hinsdale, IL
  • NPI 1174821946
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1275807158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 S KOLIN AVE UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294839",
            "telephone_number": "773-412-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 S KOLIN AVE UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294839",
            "telephone_number": "773-412-7420",
            "fax_number": "773-306-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEH",
        "first_name": "AUGUSTUS",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddi Care LLC
• Eddie Taylor PHD PLLC
• Sherida Naing Edding, M.D.
• Hadeel Eddir
• Margaret A Eddleton, RN, MSN
• David Keith Edelberg, MD
• John Francis Edelbrock V, MS
• Emily Edelman, MSW, LSW
• Guy J. Edelman
• Hillary J Edelman, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.