Individual provider Active NPI

Bruce Paul Robinson, LCSW

  • Clinical Social Worker
  • Evergreen Park, IL
National Provider Identifier
1356416689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
9730 S Western Ave
Suite 729
Evergreen Park, IL 60805-2666
Phone
(708) 499-3525
Fax
(708) 499-3515
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

9730 S Western Ave
Suite 729
Evergreen Park, IL 60805-2666

Mailing address

5322 N Glenwood Ave
Chicago, IL 60640-2219
Phone (773) 769-6503

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
I20050107000498 IL Practitioner - Clinical Social Worker 7416905252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valentin Berman MD PCGroup PAC ID 6406866896, 2 clinicians

Practice addresses (Care Compare)

10801 S Western Ave
Suite 2B
Chicago, IL 60643-3225
Phone (708) 499-3525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149006432ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mirjam Quinn and Associates, LTD CurrentSince Oct 17, 2023 Accepting new patients
Valentin Berman MD PC CurrentSince Feb 1, 2006 Accepting new patients
Ruth M Rattenbury Psy D PC Past Accepting new patients

Locations

10801 S Western Ave
Ste 2B
Chicago, IL 60643
Phone (708) 499-3525

9730 S Western Ave
Ste 729
Evergreen Pk, IL 60805
Phone (708) 499-3525

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356416689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 N GLENWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402219",
            "telephone_number": "773-769-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE",
            "address_2": "SUITE 729",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052666",
            "telephone_number": "708-499-3525",
            "fax_number": "708-499-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "BRUCE",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.