Active NPI
Brittney Bastida
- Clinical Social Worker
- Berwyn, IL
National Provider Identifier
1417740838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.031676
- Practice address
- 6201 Roosevelt Rd
Berwyn, IL 60402-1108 - Phone
- (708) 386-0835
- NPI assigned
- May 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.031676 | IL | Primary |
Addresses
Primary practice location
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Mailing address
2230 S 50TH Ave
Cicero, IL 60804-2434
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
14 Lake St
Oak Park, IL 60302-2606
6201 Roosevelt Rd
Berwyn, IL 60402-1108
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.031676 | IL | MD | Clinical Social Worker |
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.
-
- Federally Qualified Health Center (FQHC)
- Oak Park, IL
- NPI 1871516799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1417740838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2230 S 50TH AVE",
"city": "CICERO",
"state": "IL",
"postal_code": "608042434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 ROOSEVELT RD",
"city": "BERWYN",
"state": "IL",
"postal_code": "604021108",
"telephone_number": "708-386-0835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIDA",
"first_name": "BRITTNEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-28",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.031676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.