Individual provider Active NPI

Felix Manuel Rodriguez, LCSW

  • Clinical Social Worker
  • Mokena, IL
National Provider Identifier
1376873653
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149004055 Issued in IL
Practice address
19639 La Grange Rd
Mokena, IL 60448-9360
Phone
(312) 446-2013
Fax
(708) 478-3536
NPI assigned
Jan 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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 149004055 IL Primary

Addresses

Primary practice location

19639 La Grange Rd
Mokena, IL 60448-9360

Mailing address

20840 Brookside Blvd
Olympia Fields, IL 60461-1791
Phone (312) 446-2013

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
149004055ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology & Skin Surgery Associates, SC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8564/brand/1/csg/1/fhir/r4

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": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1376873653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20840 BROOKSIDE BLVD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611791",
            "telephone_number": "312-446-2013",
            "fax_number": "708-478-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19639 LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489360",
            "telephone_number": "312-446-2013",
            "fax_number": "708-478-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "FELIX",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.