Active NPI
Jeffrey Brian Devries, L.C.S.W.
- Clinical Social Worker
- Mokena, IL
National Provider Identifier
1376655464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 19646 Wolf Rd
Mokena, IL 60448-1333 - Phone
- (708) 478-1933
- Fax
- (708) 478-3089
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | IL | Primary |
Addresses
Primary practice location
19646 Wolf Rd
Mokena, IL 60448-1333
Mailing address
19646 Wolf Rd
Mokena, IL 60448-1333
Phone (708) 478-1933
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031211001001 | IL | Practitioner - Clinical Social Worker | 7911803689 | Practice locations: Tinley Park, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149-004568 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376655464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19646 WOLF RD",
"city": "MOKENA",
"state": "IL",
"postal_code": "604481333",
"telephone_number": "708-478-1933",
"fax_number": "708-478-3089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19646 WOLF RD",
"city": "MOKENA",
"state": "IL",
"postal_code": "604481333",
"telephone_number": "708-478-1933",
"fax_number": "708-478-3089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVRIES",
"first_name": "JEFFREY",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"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 Mokena, IL
- Molly Demereckis, BCBA
- Dental Professionals of Illinois, P.C.
- Kelly Derr, LCSW
- Kelly Kathleen Devereux, M.S. CCC-SLP
- Kelly L Devine, MS, RDN, LDN
- Julie Elizabeth Di Novo, FNP
- Diagnostic P.E.T. Network, LLC
- Diagnostic Services Associates, LTD.
- Dialysis Centers of America - Illinois, Inc.
- Angelica Marie Diaz, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.