Individual provider Active NPI

Daniel Lopez, M.A., LCSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1386992089
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
149.014904 Issued in IL
Practice address
2542 W North Ave
Chicago, IL 60647-5216
Phone
(773) 365-7277
Fax
(773) 365-3091
NPI assigned
Aug 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 149.014904 IL Primary

Addresses

Primary practice location

2542 W North Ave
Chicago, IL 60647-5216

Mailing address

2542 W North Ave
Chicago, IL 60647-5216
Phone (773) 365-7277

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
I20150504001762 IL Practitioner - Clinical Social Worker 3678892205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Family InstituteGroup PAC ID 1052460466, 8 clinicians

Practice addresses (Care Compare)

8 S Michigan Ave
Suite 500
Chicago, IL 60603-3307
Phone (847) 733-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
149.014904ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Institute CurrentSince Feb 1, 2017 Accepting new patients

Locations

8 S Michigan Ave
Ste 500
Chicago, IL 60603
Phone (312) 609-5300

618 Library Pl
Evanston, IL 60201
Phone (312) 609-5300

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1386992089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475216",
            "telephone_number": "773-365-7277",
            "fax_number": "773-365-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475216",
            "telephone_number": "773-365-7277",
            "fax_number": "773-365-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "M.A., LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.014904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.