Active NPI
Carolyn G. Wells
- School Social Worker
- Chicago, IL
National Provider Identifier
1447569033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 1041S0200X
- Practice address
- 10749 S Peoria St
Chicago, IL 60643-3860 - Phone
- (773) 621-9859
- NPI assigned
- Sep 29, 2010
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 1041S0200X | IL | Primary |
Addresses
Primary practice location
10749 S Peoria St
Chicago, IL 60643-3860
Mailing address
10749 S Peoria St
Chicago, IL 60643-3860
Phone (773) 621-9859
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 |
|---|---|---|---|
| 1041S0200X | IL | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1447569033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10749 S PEORIA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606433860",
"telephone_number": "773-621-9859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10749 S PEORIA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606433860",
"telephone_number": "773-621-9859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "CAROLYN",
"middle_name": "G.",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-29",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "IL",
"license": "1041S0200X",
"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 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.