Lydia Lenora Mims-Willins

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.131855 Issued in IL

Practice address

16162 Ellis Ave Ste 1N
South Holland, IL 60473-1700

Phone

(708) 378-6480

NPI assigned

Oct 8, 2026

Last updated

Oct 8, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1396640553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15314 DIEKMAN CT",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604193122",
            "telephone_number": "708-378-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16162 ELLIS AVE STE 1N",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731700",
            "telephone_number": "708-378-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMS-WILLINS",
        "first_name": "LYDIA",
        "middle_name": "LENORA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.131855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in South Holland, IL
• Providers in South Holland, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.