Individual provider Active NPI

Caroline Marie Vega

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1417711417
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026189 Issued in IL
Practice address
2551 W Peterson Ave
Chicago, IL 60659-4019
Phone
(312) 953-0731
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 36804 IL
Clinical Social Worker 1041C0700X 149.026189 IL Primary

Addresses

Primary practice location

2551 W Peterson Ave
Chicago, IL 60659-4019

Mailing address

2551 W Peterson Ave
Chicago, IL 60659-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20250502003063 IL Practitioner - Clinical Social Worker 4183141112 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36804ILMDAddiction (Substance Use Disorder) Counselor
149.026189ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trilogy, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Trilogy Inc. Current Accepting new patients
Trilogy, Inc. CurrentSince Apr 1, 2025 Accepting new patients

Locations

2551 W Peterson Ave
Chicago, IL 60659
Phone (312) 953-0731

1400 W Greenleaf Ave
Chicago, IL 60626
Phone (773) 382-4061

Organizations & group practices 3

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1417711417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594019",
            "telephone_number": "312-953-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "CAROLINE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "36804",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.