Thomas Undine

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.013059 Issued in IL

Legal business name

THOMAS UNDINE

Practice address

410 S Michigan Ave Ste 943
Chicago, IL 60605-1399

Phone

(773) 732-7700

Fax

(773) 304-3517

NPI assigned

Jun 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas R Undine, LCSW

Title

Founding Therapist

Phone

(773) 732-7700

Specialties & licenses 1

Addresses

Other names 1

• Undine and Associates Doing business as

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1366823585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S MICHIGAN AVE STE 943",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051399",
            "telephone_number": "773-732-7700",
            "fax_number": "773-304-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S MICHIGAN AVE STE 943",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051399",
            "telephone_number": "773-732-7700",
            "fax_number": "773-304-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS UNDINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "UNDINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FOUNDING THERAPIST",
        "authorized_official_telephone_number": "773-732-7700",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Undine and Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas L Pitts, MD LLC
• Thomas L. Fisher, M.D., S.C.
• Thomas M Joyce DDS LTD
• Thomas Nedderman Counseling
• Thomas R. Mizen, M.D. and Associates, LLC
• Thomas Valente M.D., P.a.
• Thomas W Sweder MD SC
• Thomas W. Pissios DDS, LTD
• Thomas Wellness Center, PLLC
• Ashley Thomas-Brown

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.