Active NPI
Deanna Gibson
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1346985306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149020528
- Practice address
- 6844 S Indiana Ave
Chicago, IL 60637-3906 - Phone
- (708) 802-4563
- NPI assigned
- May 3, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149020528 | IL | Primary |
Addresses
Primary practice location
6844 S Indiana Ave
Chicago, IL 60637-3906
Mailing address
7212 Madison Ave
Hammond, IN 46324-1910
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149020528 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1346985306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7212 MADISON AVE",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463241910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6844 S INDIANA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606373906",
"telephone_number": "708-802-4563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "DEANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-03",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149020528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.