Individual provider Active NPI

Wendy Marie Vankeulen, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1326344284
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014338 Issued in IL
Practice address
540 S Taylor Ave
Oak Park, IL 60304-1620
Phone
(773) 369-6038
Fax
(773) 475-6203
NPI assigned
Feb 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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 149014338 IL Primary

Addresses

Primary practice location

540 S Taylor Ave
Oak Park, IL 60304-1620

Mailing address

2324 W 21St PL
Chicago, IL 60608-3810
Phone (773) 369-6038

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
I20110513000087 IL Practitioner - Clinical Social Worker 1850577529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

127 W Diversey Ave
Elmhurst, IL 60126-1101
Phone (630) 530-5225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

127 W Diversey Ave
Elmhurst, IL 60126
Phone (630) 530-5225

3450 Oakton St
Ste 300
Skokie, IL 60076

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1326344284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 W 21ST PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083810",
            "telephone_number": "773-369-6038",
            "fax_number": "773-475-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S TAYLOR AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041620",
            "telephone_number": "773-369-6038",
            "fax_number": "773-475-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANKEULEN",
        "first_name": "WENDY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.