Individual provider Active NPI

Michael Scholl, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1417971326
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5691 N Ridge Ave
Chicago, IL 60660-3420
Phone
(773) 303-3000
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

5691 N Ridge Ave
Chicago, IL 60660-3420

Mailing address

1010 Williamsburg Dr
Northbrook, IL 60062-1537
Phone (847) 272-0541

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
I20050518000532 IL Practitioner - Clinical Social Worker 5496796690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149006509ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP CurrentSince Dec 2, 2016 Accepting new patients
The Josselyn Center NFP CurrentSince Dec 2, 2016 Accepting new patients
The Josselyn Center NFP Past Accepting new patients
Community Counseling Centers of Chicago Past Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (773) 430-3351

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

Organizations & group practices 4

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417971326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WILLIAMSBURG DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621537",
            "telephone_number": "847-272-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 N RIDGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603420",
            "telephone_number": "773-303-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLL",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "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.