Individual provider Active NPI

Lukasz Obrochta, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1437604568
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018610 Issued in IL
Practice address
4121 W Lake St
Chicago, IL 60624-1719
Phone
(312) 405-3557
Fax
(773) 826-2109
NPI assigned
Aug 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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 149.018610 IL Primary

Addresses

Primary practice location

4121 W Lake St
Chicago, IL 60624-1719

Mailing address

116 Mullingar CT
1B
Schaumburg, IL 60193-5614
Phone (847) 401-9564

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
149.018610ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1437604568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MULLINGAR CT",
            "address_2": "1B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601935614",
            "telephone_number": "847-401-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606241719",
            "telephone_number": "312-405-3557",
            "fax_number": "773-826-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBROCHTA",
        "first_name": "LUKASZ",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018610",
            "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 Aug 18, 2016; 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.