Individual provider Active NPI

Regina S Wells

  • Social Worker
  • Flossmoor, IL
National Provider Identifier
1396438735
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.109837 Issued in IL
Practice address
19624 Governors Hwy
Flossmoor, IL 60422-2077
Phone
(872) 225-6010
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 150.109837 IL Primary

Addresses

Primary practice location

19624 Governors Hwy
Flossmoor, IL 60422-2077

Mailing address

25113 S Chennault Ave
Monee, IL 60449-9019
Phone (708) 259-6032

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
I20250602000973 IL Practitioner - Clinical Social Worker 8426567488 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.109837ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Just & Equitable Counseling PC CurrentSince Apr 1, 2025 Accepting new patients

Locations

3020 Woodcreek Dr
Ste A2
Downers Grove, IL 60515
Phone (630) 504-8550

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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1396438735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25113 S CHENNAULT AVE",
            "city": "MONEE",
            "state": "IL",
            "postal_code": "604499019",
            "telephone_number": "708-259-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222077",
            "telephone_number": "872-225-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "REGINA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.109837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

Verify at the official NPI Registry.