Individual provider Active NPI

Courtney George, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1376905489
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018252 Issued in IL
Practice address
4840 W Byron St
Chicago, IL 60641-2712
Phone
(773) 282-7800
Fax
(773) 282-2163
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 149018252 IL Primary

Addresses

Primary practice location

4840 W Byron St
Chicago, IL 60641-2712

Mailing address

4840 W Byron St
Chicago, IL 60641-2712

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806003315 IL Practitioner - Clinical Social Worker 4981996279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Illinois Clinical Current Accepting new patients

Locations

5215 N California Ave
Ste F101
Chicago, IL 60625
Phone (773) 561-5809

4840 W Byron St
Chicago, IL 60641
Phone (773) 282-7800

1001 E Touhy Ave
Ste 50
Des Plaines, IL 60018

1001 E Touhy Ave
Ste 170
Des Plaines, IL 60018
Phone (847) 390-1422

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1376905489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 W BYRON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 W BYRON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412712",
            "telephone_number": "773-282-7800",
            "fax_number": "773-282-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.