Individual provider Active NPI

Ryan Van Voorhis

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1417399221
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012554 Issued in IL
Practice address
2346 W Augusta Blvd
1F
Chicago, IL 60622-4886
Phone
(773) 297-9359
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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 149.012554 IL Primary

Addresses

Primary practice location

2346 W Augusta Blvd
1F
Chicago, IL 60622-4886

Mailing address

2346 W Augusta Blvd
1F
Chicago, IL 60622-4886
Phone (773) 297-9359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.012554ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1417399221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2346 W AUGUSTA BLVD",
            "address_2": "1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224886",
            "telephone_number": "773-297-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 W AUGUSTA BLVD",
            "address_2": "1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224886",
            "telephone_number": "773-297-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VOORHIS",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.