Individual provider Active NPI

Genesis Guadalupe Galan Cruz

  • Clinical Social Worker
  • Berwyn, IL
National Provider Identifier
1366077877
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149028876 Issued in IL
Practice address
6918 W Windsor Ave
Berwyn, IL 60402-3334
Phone
(708) 745-5277
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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 149028876 IL Primary

Addresses

Primary practice location

6918 W Windsor Ave
Berwyn, IL 60402-3334

Mailing address

5220 East Ave
Countryside, IL 60525-3133
Phone (708) 745-5277

Other practice location 1

321 N La Grange Rd
LA Grange Park, IL 60526-5622
Phone (708) 745-5277

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
I20250903002063 IL Practitioner - Clinical Social Worker 6204338999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5220 E Ave
Countryside, IL 60525-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pillars Community Health Clinical CurrentSince May 22, 2025 Accepting new patients
Pillars Community Health CurrentSince May 22, 2025 Accepting new patients

Locations

6918 W Windsor Ave
Berwyn, IL 60402
Phone (708) 795-4800

5220 East Ave
Countryside, IL 60525

321 N La Grange Rd
La Grange Park, IL 60526
Phone (708) 485-1020

333 N La Grange Rd
La Grange Pk, IL 60526
Phone (708) 995-3506

333 N La Grange Rd
Ste 1
La Grange Pk, IL 60526
Phone (708) 995-3550

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1366077877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 EAST AVE",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253133",
            "telephone_number": "708-745-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 W WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023334",
            "telephone_number": "708-745-5277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 N La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "LA Grange Park",
            "state": "IL",
            "postal_code": "605265622",
            "country_code": "US",
            "telephone_number": "708-745-5277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALAN CRUZ",
        "first_name": "GENESIS",
        "middle_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149028876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.