Individual provider Active NPI

Tiffany Micek, LCSW

  • Clinical Social Worker
  • Libertyville, IL
National Provider Identifier
1295431484
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026327 Issued in IL
Practice address
1860 W Winchester Rd Ste 205
Libertyville, IL 60048-5317
Phone
(224) 424-4102
NPI assigned
Jan 31, 2023
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.026327 IL Primary
Social Worker 104100000X 150106104 IL

Addresses

Primary practice location

1860 W Winchester Rd Ste 205
Libertyville, IL 60048-5317

Mailing address

1425 Melrose Ave
Round Lake Beach, IL 60073-2059
Phone (847) 773-7474

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
I20250206002666 IL Practitioner - Clinical Social Worker 5496285363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

1920 Nerge Rd
Elk Grove Village, IL 60007-2972
Phone (847) 301-0550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150106104ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC CurrentSince Dec 31, 2024 Accepting new patients

Locations

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

1920 Nerge Rd
Elk Grove Vlg, IL 60007
Phone (847) 301-0550

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1295431484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MELROSE AVE",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600732059",
            "telephone_number": "847-773-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD STE 205",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485317",
            "telephone_number": "224-424-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICEK",
        "first_name": "TIFFANY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026327",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150106104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.