Individual provider Active NPI

Linda Weiss

  • Clinical Social Worker
  • Waukegan, IL
National Provider Identifier
1336682137
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149005687 Issued in IL
Practice address
2025 Washington St
Waukegan, IL 60085-5131
Phone
(847) 360-1020
Fax
(847) 360-1065
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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 149005687 IL Primary

Addresses

Primary practice location

2025 Washington St
Waukegan, IL 60085-5131

Mailing address

2025 Washington St
Waukegan, IL 60085-5131
Phone (847) 360-1020

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
I20170418001697 IL Practitioner - Clinical Social Worker 0547546046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149005687ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP CurrentSince Oct 29, 2020 Accepting new patients
The Josselyn Center NFP CurrentSince Oct 29, 2020 Accepting new patients
The Josselyn Center NFP Past Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (773) 430-3351

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1336682137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855131",
            "telephone_number": "847-360-1020",
            "fax_number": "847-360-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855131",
            "telephone_number": "847-360-1020",
            "fax_number": "847-360-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "LINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.