The Shekinah Triad PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008999 Issued in IL

Legal business name

THE SHEKINAH TRIAD PC

Practice address

2016 N Kennicott
Arlington Heights, IL 60004-2922

Phone

(847) 220-1331

Fax

(847) 398-3099

NPI assigned

Nov 7, 2006

Last updated

Oct 6, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Marilyn Joanne NadulekNPI 1144401332

Title

President Clinical Director

Phone

(847) 220-1331

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marilyn Joanne Nadulek, LCSW

  • Clinical Social Worker
  • Arlington Heights, IL
  • NPI 1144401332
  Authorized official Same address or phone

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1417026022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 N KENNICOTT",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042922",
            "telephone_number": "847-220-1331",
            "fax_number": "847-398-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 N KENNICOTT",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042922",
            "telephone_number": "847-220-1331",
            "fax_number": "847-398-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHEKINAH TRIAD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "NADULEK",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "PRESIDENT CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "847-220-1331",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.