Individual provider Active NPI

Jane Montgomery

  • Clinical Social Worker
  • Woodstock, IL
National Provider Identifier
1386012730
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020272 Issued in IL
Practice address
715 W Judd St
Woodstock, IL 60098
Phone
(815) 527-7300
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 149.020272 IL Primary

Addresses

Primary practice location

715 W Judd St
Woodstock, IL 60098

Mailing address

825 Village Cir
Marengo, IL 60152-3637
Phone (815) 861-7648

Other practice location 1

527 W South St
Woodstock, IL 60098-3756
Phone (815) 338-2910

Other practice location 2

145 S Virginia St Ste C
Crystal Lake, IL 60014-7226
Phone (814) 535-6668

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
I20180904001373 IL Practitioner - Clinical Social Worker 0941550412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Reasons Health, PLLCGroup PAC ID 7618314378, 5 clinicians
Sondermind PCGroup PAC ID 0547795791, 64 clinicians

Practice addresses (Care Compare)

333 Commerce Dr
Suite 600
Crystal Lake, IL 60014-3598
Phone (815) 404-0595

416 Main St
Suite 601
Peoria, IL 61602-3126
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.020272ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind PC Clinical CurrentSince Aug 1, 2025 Accepting new patients
Cornerstone Care, Inc. Current Accepting new patients
Reasons Health, PLLC CurrentSince Jul 10, 2024 Accepting new patients

Locations

333 Commerce Dr
Ste 600
Crystal Lake, IL 60014
Phone (779) 356-4095

416 Main St
Ste 601
Peoria, IL 61602
Phone (309) 945-3305

645 McHenry Ave
Woodstock, IL 60098
Phone (815) 334-0411

Organizations & group practices 3

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": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1386012730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 VILLAGE CIR",
            "city": "MARENGO",
            "state": "IL",
            "postal_code": "601523637",
            "telephone_number": "815-861-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W JUDD ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-527-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 W South St",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600983756",
            "country_code": "US",
            "telephone_number": "815-338-2910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 S Virginia St Ste C",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147226",
            "country_code": "US",
            "telephone_number": "814-535-6668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.