Individual provider Active NPI

Mai Lynn Grajewski, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1336477645
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013434 Issued in IL
Practice address
1640 W Roosevelt Rd
Chicago, IL 60608-1316
Phone
(312) 413-1871
NPI assigned
Nov 24, 2009
Last updated
Nov 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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 149013434 IL Primary

Addresses

Primary practice location

1640 W Roosevelt Rd
Chicago, IL 60608-1316

Mailing address

1640 W Roosevelt Rd
Chicago, IL 60608-1316
Phone (312) 413-1871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149013434ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Jan 12, 2020 Accepting new patients
Erie Family Health Center Inc CurrentSince Jan 12, 2020 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients

Locations

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-2056

2750 W North Ave
Chicago, IL 60647
Phone (312) 432-2767

Organizations & group practices 3

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1336477645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081316",
            "telephone_number": "312-413-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081316",
            "telephone_number": "312-413-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJEWSKI",
        "first_name": "MAI LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.