Individual provider Active NPI

Jill J Scott-Trainer, MSW, LCSW

  • Clinical Social Worker
  • Lisle, IL
National Provider Identifier
1275861189
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011173 Issued in IL
Practice address
4300 Commerce CT Ste 300-10
Lisle, IL 60532-3709
Phone
(630) 699-5279
Fax
(630) 297-7583
NPI assigned
Dec 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 149.011173 IL Primary

Addresses

Primary practice location

4300 Commerce CT Ste 300-10
Lisle, IL 60532-3709

Mailing address

4435 Shabbona LN
Lisle, IL 60532-1058
Phone (630) 699-5279

Other identifiers 1

IdentifierTypeStateIssuer
12087907OtherCAQH

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
I20210217002050 IL Practitioner - Clinical Social Worker 8224443643 Practice locations: Lisle, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4300 Commerce CT
Lisle, IL 60532-3709
Phone (630) 699-5279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1275861189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 SHABBONA LN",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321058",
            "telephone_number": "630-699-5279",
            "fax_number": "630-297-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 COMMERCE CT STE 300-10",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323709",
            "telephone_number": "630-699-5279",
            "fax_number": "630-297-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT-TRAINER",
        "first_name": "JILL",
        "middle_name": "J",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12087907",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.