Individual provider Active NPI

Marissa Lynn Latko

  • Clinical Social Worker
  • Mokena, IL
National Provider Identifier
1285112359
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
11869 Golden Gate Dr
Mokena, IL 60448-2027
Phone
(708) 277-4121
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 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 Primary

Addresses

Primary practice location

11869 Golden Gate Dr
Mokena, IL 60448-2027

Mailing address

11869 Golden Gate Dr
Mokena, IL 60448-2027
Phone (708) 277-4121

Other practice location 1

1010 Lake St
Oak Park, IL 60301-1147
Phone (630) 428-7890

Other practice location 2

18425 W Creek Dr Ste D
Tinley Park, IL 60477-6768
Phone (800) 361-6880

Other practice location 3

15127 S 73rd Ave Ste G
Orland Park, IL 60462-3425
Phone (800) 361-6880

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
I20230901001748 IL Practitioner - Clinical Social Worker 7214390624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11869 Golden Gate Dr
Mokena, IL 60448-2027
Phone (708) 227-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Aug 7, 2023 Accepting new patients
Hope in Healing Therapy, PLLC Clinical CurrentSince Nov 1, 2023 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients
Chicago Christian Counseling Center Inc Clinical PastSince Feb 1, 2010 Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

581 Elm Pl
Ste 110
Highland Park, IL 60035
Phone (847) 861-7771

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

15303 S 94th Ave
Ste 250
Orland Park, IL 60462
Phone (708) 505-5205

Organizations & group practices 4

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1285112359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11869 GOLDEN GATE DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482027",
            "telephone_number": "708-277-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11869 GOLDEN GATE DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482027",
            "telephone_number": "708-277-4121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Lake St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011147",
            "country_code": "US",
            "telephone_number": "630-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18425 W Creek Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604776768",
            "country_code": "US",
            "telephone_number": "800-361-6880",
            "fax_number": "708-845-5505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15127 S 73rd Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604623425",
            "country_code": "US",
            "telephone_number": "800-361-6880",
            "fax_number": "708-845-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATKO",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.