NPIMap

Organization Active NPI

Ideas Magicas

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1477908176
Registry record updated Apr 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012310 Issued in IL
Legal business name
IDEAS MAGICAS
Practice address
4501 S Washtenaw Ave
Chicago, IL 60632-1942
Phone
(773) 704-3948
Fax
(773) 453-3307
NPI assigned
Apr 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Martha A. Rodriguez
Title
Manager
Phone
(773) 704-3948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149.012310 IL Primary

Addresses

Primary practice location

4501 S Washtenaw Ave
Chicago, IL 60632-1942

Mailing address

4501 S Washtenaw Ave
Chicago, IL 60632-1942
Phone (773) 704-3948

Other identifiers 1

IdentifierTypeStateIssuer
1194957050OtherILSOCIAL WORKER CLINICAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1461974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461974400000",
    "number": "1477908176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 S WASHTENAW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321942",
            "telephone_number": "773-704-3948",
            "fax_number": "773-453-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S WASHTENAW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321942",
            "telephone_number": "773-704-3948",
            "fax_number": "773-453-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAS MAGICAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-30",
        "last_updated": "2016-04-30",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-704-3948",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER CLINICAL",
            "identifier": "1194957050",
            "state": "IL"
        }
    ],
    "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 Apr 30, 2016; 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.