Individual provider Active NPI

Isaac Obenzinger, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1407364219
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019728 Issued in IL
Practice address
2740 W Foster Ave Ste 412
Chicago, IL 60625-3532
Phone
(773) 878-8200
Fax
(773) 293-5346
NPI assigned
Jan 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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 149019728 IL Primary

Addresses

Primary practice location

2740 W Foster Ave Ste 412
Chicago, IL 60625-3532

Mailing address

2740 W Foster Ave Ste 310
Chicago, IL 60625-3547
Phone (773) 878-8200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iobenzinger277143@direct.northshore.org

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
I20180208002248 IL Practitioner - Clinical Social Worker 0345500575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2740 W Foster Ave
Chicago, IL 60625-3547

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149019728ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc CurrentSince Feb 1, 2018 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 15, 2023 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Feb 1, 2018 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste 310
Chicago, IL 60625

2740 W Foster Ave
Ste 412
Chicago, IL 60625
Phone (773) 293-4362

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: iobenzinger277143@direct.northshore.org

Organizations & group practices 4

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": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1407364219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253547",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 412",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253532",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENZINGER",
        "first_name": "ISAAC",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iobenzinger277143@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2740 W Foster Ave Ste 412",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606253532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.