Individual provider Active NPI

Jaime Esquivel, LCSW

  • Counselor
  • Chicago, IL
National Provider Identifier
1285812925
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2525 W Peterson Ave
C4
Chicago, IL 60659-4108
Phone
(773) 506-2525
Fax
(773) 765-0622
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Clinical Social Worker 1041C0700X 149.014660 IL

Addresses

Primary practice location

2525 W Peterson Ave
C4
Chicago, IL 60659-4108

Mailing address

1419 W Farragut Ave
Chicago, IL 60640-2103
Phone (773) 293-2910

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
I20150619001799 IL Practitioner - Clinical Social Worker 0840501631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014660ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Illinois Clinical CurrentSince Jul 13, 2015 Accepting new patients
Lutheran Social Services of Illinois Clinical CurrentSince Jul 13, 2015 Accepting new patients

Locations

5215 N California Ave
Ste F101
Chicago, IL 60625
Phone (773) 561-5809

4840 W Byron St
Chicago, IL 60641
Phone (773) 282-7800

1001 E Touhy Ave
Ste 170
Des Plaines, IL 60018
Phone (847) 390-1422

Organizations & group practices 2

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1285812925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 W FARRAGUT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402103",
            "telephone_number": "773-293-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W PETERSON AVE",
            "address_2": "C4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594108",
            "telephone_number": "773-506-2525",
            "fax_number": "773-765-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "JAIME",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.