Individual provider Active NPI

Lisa Nagatomo-Timms, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1417927344
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2800 N Sheridan Rd
Suite 502
Chicago, IL 60657-6156
Phone
(773) 404-0160
Fax
(773) 404-9876
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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 IL Primary

Addresses

Primary practice location

2800 N Sheridan Rd
Suite 502
Chicago, IL 60657-6156

Mailing address

2800 N Sheridan Rd
Suite 502
Chicago, IL 60657-6156
Phone (773) 404-0160

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
I20090914000608 IL Practitioner - Clinical Social Worker 5193871366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theodore Handrup MD LTDGroup PAC ID 5294709887, 7 clinicians

Practice addresses (Care Compare)

3000 N Halsted St
Suite 802
Chicago, IL 60657-6185
Phone (773) 472-1483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore Handrup MD LTD CurrentSince Aug 9, 2009 Accepting new patients

Locations

3000 N Halsted St
Ste 802
Chicago, IL 60657

2800 N Sheridan Rd
Ste 502
Chicago, IL 60657
Phone (773) 472-1483

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1417927344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGATOMO-TIMMS",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.