Individual provider Active NPI

Ryan Weinstock, LCSW

  • Clinical Social Worker
  • La Grange Park, IL
National Provider Identifier
1447748389
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020257 Issued in IL
Practice address
412 Homestead Rd Apt 1
La Grange Park, IL 60526-2145
Phone
(847) 913-5959
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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 149.020257 IL Primary

Addresses

Primary practice location

412 Homestead Rd Apt 1
La Grange Park, IL 60526-2145

Mailing address

412 Homestead Rd Apt 1
La Grange Park, IL 60526-2145
Phone (847) 913-5959

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
149.020257ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1447748389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 HOMESTEAD RD APT 1",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605262145",
            "telephone_number": "847-913-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 HOMESTEAD RD APT 1",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605262145",
            "telephone_number": "847-913-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTOCK",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.