Individual provider Active NPI

Marcos Constantino Jr.

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1346083094
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027153 Issued in IL
Practice address
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone
(773) 257-7475
NPI assigned
Jun 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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 149.027153 IL Primary

Addresses

Primary practice location

1500 S Fairfield Ave
Chicago, IL 60608-1782

Mailing address

2525 S Whipple St Apt 2
Chicago, IL 60623-4139
Phone (773) 993-9014

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
149.027153ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Dec 21, 2024 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince Dec 21, 2024 Accepting new patients

Locations

1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

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": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1346083094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S WHIPPLE ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234139",
            "telephone_number": "773-993-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "773-257-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINO",
        "first_name": "MARCOS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.