Active NPI
Jacqueline I Wert, MSW, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1447359815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-005499
- Practice address
- 6122 N. Mozart St., 2ND Floor
Chicago, IL 60659-2570 - Phone
- (773) 262-8018
- Fax
- (773) 262-8019
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 149-005499 | IL | Primary |
Addresses
Primary practice location
6122 N. Mozart St., 2ND Floor
Chicago, IL 60659-2570
Mailing address
6122 N. Mozart St., 2ND Floor
Chicago, IL 60659-2570
Phone (773) 262-8018
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 421511 | Other | MHN-A HEALTH NET COMPANY | |
| 7458520 | Other | AETNA | |
| 457938 | Other | VALUE OPTIONS | |
| 01632633 | Other | IL | BLUE SHIELD |
| 01632633 | Other | IL | BCBS IL |
| 197050 | Other | COMPSYCH | |
| 298234-000 | Other | IL | MAGELLAN BEHAVIORAL HEALT |
| 6235409 | Other | UNITED BEHAVIORAL HEALTH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149-005499 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1447359815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6122 N. MOZART ST., 2ND FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606592570",
"telephone_number": "773-262-8018",
"fax_number": "773-262-8019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6122 N. MOZART ST., 2ND FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606592570",
"telephone_number": "773-262-8018",
"fax_number": "773-262-8019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERT",
"first_name": "JACQUELINE",
"middle_name": "I",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-005499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN-A HEALTH NET COMPANY",
"identifier": "421511",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7458520",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "457938",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "01632633",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IL",
"identifier": "01632633",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "197050",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "298234-000",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "6235409",
"state": null
}
],
"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 Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.