Individual provider Active NPI

Jessica Hinterman, LCSW

  • Clinical Social Worker
  • Park Forest, IL
National Provider Identifier
1346455862
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-001964 Issued in IL
Practice address
146 Chestnut St
Park Forest, IL 60466-2169
Phone
(708) 595-2960
NPI assigned
May 10, 2007
Last updated
Apr 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 149-001964 IL Primary

Addresses

Primary practice location

146 Chestnut St
Park Forest, IL 60466-2169

Mailing address

146 Chestnut St
Park Forest, IL 60466
Phone (708) 481-6599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-001964ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1346455862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 CHESTNUT ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "60466",
            "telephone_number": "708-481-6599",
            "fax_number": "708-481-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 CHESTNUT ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662169",
            "telephone_number": "708-595-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTERMAN",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-001964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.