Individual provider Active NPI

Timothy Seals

  • Social Worker
  • Calumet City, IL
National Provider Identifier
1427735695
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150109342 Issued in IL
Practice address
1265 Cunningham Dr Apt 215
Calumet City, IL 60409-5633
Phone
(312) 975-9017
NPI assigned
Jun 29, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150109342 IL Primary

Addresses

Primary practice location

1265 Cunningham Dr Apt 215
Calumet City, IL 60409-5633

Mailing address

1265 Cunningham Dr Apt 215
Calumet City, IL 60409-5633
Phone (312) 975-9017

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
150109342ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1427735695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 CUNNINGHAM DR APT 215",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095633",
            "telephone_number": "312-975-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 CUNNINGHAM DR APT 215",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095633",
            "telephone_number": "312-975-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALS",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150109342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.