Individual provider Active NPI

Richard L Madison, LCSW

  • Clinical Social Worker
  • Joliet, IL
National Provider Identifier
1407988520
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-002698 Issued in IL
Practice address
210 N Hammes Ave
Suite 103
Joliet, IL 60435-6680
Phone
(815) 942-6323
Fax
(815) 942-6423
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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 149-002698 IL Primary

Addresses

Primary practice location

210 N Hammes Ave
Suite 103
Joliet, IL 60435-6680

Mailing address

1401 Lakewood Dr
Suite a
Morris, IL 60450-3352
Phone (815) 942-6323

Other identifiers 1

IdentifierTypeStateIssuer
149-002698OtherILLCSW

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
I20110307001028 IL Practitioner - Clinical Social Worker 7618159070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joliet Center for Clinical Research, IncGroup PAC ID 3971662842, 9 clinicians

Practice addresses (Care Compare)

210 N Hammes Ave
Suite 205
Joliet, IL 60435-8139
Phone 8157297790102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-002698ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joliet Center for Clinical Research, Inc CurrentSince Oct 8, 2018 Accepting new patients

Locations

210 N Hammes Ave
Ste 205
Joliet, IL 60435
Phone (815) 729-7790

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1407988520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE",
            "address_2": "SUITE 103",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356680",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "RICHARD",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-002698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149-002698",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.