Active NPI
Stacy A Kissamis, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1437935699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.021599
- Practice address
- 200 N. Lasalle Street
Chicago, IL 60601 - Phone
- (888) 660-4425
- NPI assigned
- Sep 5, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.021599 | IL | Primary |
Addresses
Primary practice location
200 N. Lasalle Street
Chicago, IL 60601
Mailing address
605 Academy CT
Schaumburg, IL 60194-2501
Phone (630) 432-7044
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 E Pells St
Paxton, IL 60957-1300
Phone (888) 705-8722
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.021599 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Post Acute Care PLLC | Clinical | Current | Accepting new patients |
Locations
2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437
1001 E Pells St
Paxton, IL 60957
Phone (217) 379-4361
Organizations & group practices 1
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": "1693872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1437935699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 ACADEMY CT",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601942501",
"telephone_number": "630-432-7044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N. LASALLE STREET",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60601",
"telephone_number": "888-660-4425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISSAMIS",
"first_name": "STACY",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-05",
"last_updated": "2023-09-07",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.021599",
"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 Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.