Individual provider Active NPI

Angela Michelle Wuebben, LCSW

  • Clinical Social Worker
  • Buffalo Grove, IL
National Provider Identifier
1477266211
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.025151 Issued in IL
Practice address
1110 W Lake Cook Rd
Buffalo Grove, IL 60089-1944
Phone
(815) 669-9640
NPI assigned
Dec 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 149.025151 IL Primary

Addresses

Primary practice location

1110 W Lake Cook Rd
Buffalo Grove, IL 60089-1944

Mailing address

1110 W Lake Cook Rd
Buffalo Grove, IL 60089-1944
Phone (815) 669-9640

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
I20230120001749 IL Practitioner - Clinical Social Worker 3173994613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

444 N Northwest Hwy
Suite 202
Park Ridge, IL 60068-3271
Phone (847) 692-7101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.025151ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Dec 30, 2025 Accepting new patients

Locations

444 N Northwest Hwy
Ste 202
Park Ridge, IL 60068
Phone (847) 268-0280

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

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": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1477266211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W LAKE COOK RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891944",
            "telephone_number": "815-669-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W LAKE COOK RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891944",
            "telephone_number": "815-669-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUEBBEN",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.