Individual provider Active NPI

Christian Robert Locke, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1407949720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
800 W 5TH Ave
Suite 205G
Naperville, IL 60563-8965
Phone
(630) 913-7045
Fax
(630) 428-3593
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

800 W 5TH Ave
Suite 205G
Naperville, IL 60563-8965

Mailing address

705 N Sparkle CT
Oswego, IL 60543-7942
Phone (630) 913-7045

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
I20061024000299 IL Practitioner - Clinical Social Worker 6002813607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Behavioral Health, P.C.Group PAC ID 7911904503, 2 clinicians

Practice addresses (Care Compare)

705 N Sparkle CT
Oswego, IL 60543-7942
Phone (630) 913-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010263ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Behavioral Health, P.C. Clinical CurrentSince Aug 1, 2006 Accepting new patients
Dunham Counseling Center, LTD. Clinical PastSince Sep 29, 2008 Accepting new patients

Locations

525 S Washington St
Naperville, IL 60540
Phone (630) 637-9300

800 W 5th Ave
Ste 205G
Naperville, IL 60563
Phone (630) 913-7045

525 S Washington St
Ste 7
Naperville, IL 60540
Phone (630) 913-7045

58 Chicago Rd
Fl 2
Oswego, IL 60543

58 Chicago Rd
#2
Oswego, IL 60543
Phone (630) 913-7045

Organizations & group practices 2

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407949720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N SPARKLE CT",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437942",
            "telephone_number": "630-913-7045",
            "fax_number": "630-428-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "address_2": "SUITE 205G",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638965",
            "telephone_number": "630-913-7045",
            "fax_number": "630-428-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "CHRISTIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.