Active NPI
Raymond Scott Pfledderer, LSW
- Social Worker
- Chicago, IL
National Provider Identifier
1427807973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.113490
- Practice address
- 3605 W Fillmore St
Chicago, IL 60624-4310 - Phone
- (773) 588-0180
- NPI assigned
- May 16, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.113490 | IL | Primary |
Addresses
Primary practice location
3605 W Fillmore St
Chicago, IL 60624-4310
Mailing address
8630 Maple Ave
Gary, IN 46403-1423
Phone (773) 458-4400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150.113490 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715817600000",
"number": "1427807973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8630 MAPLE AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464031423",
"telephone_number": "773-458-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 W FILLMORE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606244310",
"telephone_number": "773-588-0180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFLEDDERER",
"first_name": "RAYMOND",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-16",
"last_updated": "2024-05-16",
"certification_date": "2024-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.113490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.