Individual provider Active NPI

Jose Frau

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1457806093
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012632 Issued in IL
Practice address
9669 Kenton Ave Ste 204
Skokie, IL 60076-1227
Phone
(847) 425-6400
NPI assigned
Aug 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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 149012632 IL Primary

Addresses

Primary practice location

9669 Kenton Ave Ste 204
Skokie, IL 60076-1227

Mailing address

9669 Kenton Ave Ste 204
Skokie, IL 60076-1227
Phone (847) 425-6400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfrau262421@direct.northshore.org

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

LicenseStateTypeSpecialty
149012632ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1457806093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE STE 204",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761227",
            "telephone_number": "847-425-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE STE 204",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761227",
            "telephone_number": "847-425-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAU",
        "first_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfrau262421@direct.northshore.org",
            "affiliation": "N",
            "address_1": "9669 Kenton Ave Ste 204",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600761227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.