Individual provider Active NPI

Angel Jenelle Williams, MSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1366760837
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-013510 Issued in IL
Practice address
6250W North Ave 1
Chicago, IL 60639-3861
Phone
(773) 622-6218
Fax
(773) 622-7440
NPI assigned
May 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 149-013510 IL Primary

Addresses

Primary practice location

6250W North Ave 1
Chicago, IL 60639-3861

Mailing address

6250 W North Ave FL 1
Chicago, IL 60639-3861
Phone (773) 622-6218

Other practice location 1

1255 W 18th St
Chicago, IL 60608-3242
Phone (773) 622-6218

Other practice location 2

3166 N Lincoln Ave Ste 224
Chicago, IL 60657-3119
Phone (773) 622-6218

Other names 1

  • Angel Jenelle Cole Former name

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
149-013510ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Association of Greater Elgin Area Past Accepting new patients

Organizations & group practices 1

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": "1273276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366760837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 W NORTH AVE FL 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393861",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250W NORTH AVE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393861",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606083242",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3166 N Lincoln Ave Ste 224",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573119",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANGEL",
        "middle_name": "JENELLE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-013510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "COLE",
            "middle_name": "JENELLE",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 17, 2018; 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.