Jeffrey Samuels

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149023499 Issued in IL

Practice address

1011 W Wellington Ave Ste 210
Chicago, IL 60657-7187

Phone

(312) 900-8642

NPI assigned

Mar 4, 2019

Last updated

Feb 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. David Rakofsky PCGroup PAC ID 6103001797, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dr. David Rakofsky PC

  • Clinic/Center
  • Chicago, IL
  • NPI 1760663322
  Medicare reassignment Care Compare group NPD
• Dr. David Rakofsky PC

  dba Wellington Counseling Group

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1215317508
  NPD

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1316405814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-900-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W WELLINGTON AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577187",
            "telephone_number": "312-900-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.wellingtoncounselinggroup.com",
            "affiliation": "N",
            "address_1": "1011 W Wellington Ave Ste 210",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606577187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tonia Samuel, APRN-CNP
• Samuels Care Center S C
• Analiese Samuels
• Barbara Samuels, LCSW
• Gabriella Grace Samuels, LCPC
• Joseph Bradley Samuels, PA-C
• Kayla Nichole Samuels
• Kerby Ashley Samuels, M.D.
• Vicki R Samuels, M.D.
• Isaac William Samuelson, LPC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.