Active NPI
Melody Cruz, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1447984091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.021693
- Practice address
- 2500 W Bradley PL
Chicago, IL 60618-4716 - Phone
- (737) 395-5877
- NPI assigned
- Jul 11, 2022
- 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 | 149.021693 | IL | Primary |
Addresses
Primary practice location
2500 W Bradley PL
Chicago, IL 60618-4716
Mailing address
60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone (243) 061-8792
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 |
|---|---|---|---|
| 149.021693 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1447984091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 REVERE DR STE 100",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621590",
"telephone_number": "243-061-8792",
"fax_number": "224-306-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W BRADLEY PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606184716",
"telephone_number": "737-395-5877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "MELODY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.021693",
"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 Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.