Individual provider Active NPI

Melissa Ann McGinnis, MSW, LCSW

  • Clinical Social Worker
  • La Grange, IL
National Provider Identifier
1306387253
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017787 Issued in IL
Practice address
5409 S Brainard Ave
La Grange, IL 60525-6606
Phone
(312) 399-5982
NPI assigned
Mar 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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 149.017787 IL Primary

Addresses

Primary practice location

5409 S Brainard Ave
La Grange, IL 60525-6606

Mailing address

5409 S Brainard Ave
La Grange, IL 60525-6606
Phone (312) 399-5982

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
I20181108002635 IL Practitioner - Clinical Social Worker 5294089355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restoring Wellness Clinical Services PLLCGroup PAC ID 3274954722, 7 clinicians

Practice addresses (Care Compare)

200 S Frontage Rd
Suite 320
Burr Ridge, IL 60527-6953
Phone (630) 423-5998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017787ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Wellness Clinical Services, PLLC Clinical CurrentSince Jun 1, 2020 Accepting new patients

Locations

200 S Frontage Rd
Ste 320
Burr Ridge, IL 60527
Phone (630) 337-8006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1306387253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 S BRAINARD AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256606",
            "telephone_number": "312-399-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 S BRAINARD AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256606",
            "telephone_number": "312-399-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-12",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

Verify at the official NPI Registry.