Individual provider Active NPI

Kahan Sablo, LSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1346061132
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.113693 Issued in IL
Practice address
3353 S Morgan St
Chicago, IL 60608-6884
Phone
(773) 296-2400
NPI assigned
Oct 23, 2024
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.113693 IL Primary

Addresses

Primary practice location

3353 S Morgan St
Chicago, IL 60608-6884

Mailing address

2249 E 92ND St
Chicago, IL 60617-3839

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
I20250204003703 IL Practitioner - Clinical Social Worker 9931639036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

3416 S Halsted St
Chicago, IL 60608-6708
Phone (773) 296-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.113693ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baal Perazim Wellness, Inc CurrentSince Nov 30, 2024 Accepting new patients
Baal Perazim Wellness, Inc Past Accepting new patients

Locations

2835 N Sheffield Ave
Ste 500
Chicago, IL 60657
Phone (773) 525-6955

3416 S Halsted St
Chicago, IL 60608
Phone (773) 451-9444

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21150/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1346061132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 E 92ND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 S MORGAN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606086884",
            "telephone_number": "773-296-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABLO",
        "first_name": "KAHAN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.113693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.