Marco Formigoni, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014838 Issued in IL

Practice address

246 Elgin Ave
Forest Park, IL 60130-1306

Phone

(312) 945-6723

NPI assigned

Nov 2, 2013

Last updated

Nov 2, 2013By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383350400000",
    "number": "1295164093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 ELGIN AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301306",
            "telephone_number": "312-945-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 ELGIN AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301306",
            "telephone_number": "312-945-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMIGONI",
        "first_name": "MARCO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese Gottfreid Fletcher, MSW, LCSW
• Rosalia Maria Foit, PT
• Forest Park Dental Associates LTD
• Forest Park School District 91
• Forest Park, L.L.C. (Pavillion of Forest Park, L.L.C.)
• Foward Momentum Counseling PLLC (Yesenia Romo)
• Fringe Counseling, Coaching, and Consulting
• Elsy Cecilia Fuentes
• Chante Gamby, LCSW
• Anthony J Garreffa

• Clinical Social Worker in Forest Park, IL
• Providers in Forest Park, 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 Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.