Individual provider Active NPI

Robert J Latiker, LSW

  • Clinical Social Worker
  • Bourbonnais, IL
National Provider Identifier
1427832112
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
150107880 Issued in IL
Practice address
755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393
Phone
(888) 428-7890
NPI assigned
Aug 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 150107880 IL Primary

Addresses

Primary practice location

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393

Mailing address

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393
Phone (789) 063-0428

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
150107880ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1427832112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393",
            "telephone_number": "789-063-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393",
            "telephone_number": "888-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIKER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150107880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.