Individual provider Active NPI

Sandra Chechowich Johnson, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1366952731
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019688 Issued in IL
Practice address
221 E Cullerton St
Chicago, IL 60616-1386
Phone
(312) 315-4199
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 149.019688 IL Primary

Addresses

Primary practice location

221 E Cullerton St
Chicago, IL 60616-1386

Mailing address

221 E Cullerton St
Chicago, IL 60616-1386
Phone (312) 315-4199

Other practice location 1

1840 Oak Ave Ste 302
Evanston, IL 60201-3642
Phone (847) 256-7334 ext. 105

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

LicenseStateTypeSpecialty
149.019688ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366952731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E CULLERTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161386",
            "telephone_number": "312-315-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E CULLERTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161386",
            "telephone_number": "312-315-4199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Oak Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602013642",
            "country_code": "US",
            "telephone_number": "847-256-7334 x105",
            "fax_number": "847-256-7370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SANDRA",
        "middle_name": "CHECHOWICH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019688",
            "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 Jul 21, 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.

Verify at the official NPI Registry.