Individual provider Active NPI

Elizabeth J. Simon-Roper, LCSW

  • Clinical Social Worker
  • Long Grove, IL
National Provider Identifier
1326118472
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-002458 Issued in IL
Practice address
4180 State Highway 83
Suite 204
Long Grove, IL 60047
Phone
(224) 688-8167
Fax
(847) 356-5470
NPI assigned
Nov 8, 2006
Last updated
Apr 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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 149-002458 IL Primary
Clinical Social Worker 1041C0700X 2412-123 WI

Addresses

Primary practice location

4180 State Highway 83
Suite 204
Long Grove, IL 60047

Mailing address

38735 N Munn Rd
Lake Villa, IL 60046-7764
Phone (847) 356-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149-002458ILMDClinical Social Worker
2412-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1326118472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38735 N MUNN RD",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600467764",
            "telephone_number": "847-356-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 STATE HIGHWAY 83",
            "address_2": "SUITE 204",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "224-688-8167",
            "fax_number": "847-356-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON-ROPER",
        "first_name": "ELIZABETH",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-002458",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2412-123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.