Individual provider Active NPI

Lisa Marie Diaz Andrews, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1447747886
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149020269 Issued in IL
Practice address
3033 W Touhy Ave
Chicago, IL 60645-2833
Phone
(773) 508-4742
Fax
(773) 508-1112
NPI assigned
Apr 20, 2018
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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 149020269 IL Primary

Addresses

Primary practice location

3033 W Touhy Ave
Chicago, IL 60645-2833

Mailing address

4610 N Clark St # 1187
Chicago, IL 60640-4620

Other practice location 1

1239 Darrow Ave
Evanston, IL 60202-1113
Phone (312) 380-6201

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180510001584 IL Practitioner - Clinical Social Worker 4385908722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Council for Jewish ElderlyGroup PAC ID 8224932702, 20 clinicians

Practice addresses (Care Compare)

1551 Lake Cook Rd
Deerfield, IL 60015-5651
Phone (847) 374-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Jewish Elderly Clinical CurrentSince Apr 1, 2018 Accepting new patients
Lisa Andrews, LCSW, PLLC Clinical CurrentSince Jul 3, 2022 Accepting new patients

Locations

3003 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

3033 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

4610 N Clark St
Chicago, IL 60640
Phone (312) 970-1787

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1447747886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 N CLARK ST # 1187",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452833",
            "telephone_number": "773-508-4742",
            "fax_number": "773-508-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1239 Darrow Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602021113",
            "country_code": "US",
            "telephone_number": "312-380-6201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "LISA",
        "middle_name": "MARIE DIAZ",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.