Nichole Natalie Pezeshki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.019481 Issued in IL

Practice address

4400 W 95TH St Ste 404
Oak Lawn, IL 60453-7216

Phone

(708) 684-3980

NPI assigned

Aug 25, 2017

Last updated

Dec 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: npezeshki208301@direct.myadvocateaurora.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1396262879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 404",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537216",
            "telephone_number": "708-684-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKI",
        "first_name": "NICHOLE",
        "middle_name": "NATALIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npezeshki208301@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 W 95th St Ste 404",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604537216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 404",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604537216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.

Verify at the official NPI Registry.