Individual provider Active NPI

Philip J Leverette, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1487012704
Registry record updated Feb 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015958 Issued in IL
Practice address
3166 N Lincoln Ave
Chicago, IL 60657-3133
Phone
(773) 621-0616
NPI assigned
Feb 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 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 149015958 IL Primary

Addresses

Primary practice location

3166 N Lincoln Ave
Chicago, IL 60657-3133

Mailing address

5050 N Sheridan Rd
Apt 1009
Chicago, IL 60640-6413
Phone (773) 621-0616

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
149015958ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517616000000",
    "number": "1487012704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 N SHERIDAN RD",
            "address_2": "APT 1009",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606406413",
            "telephone_number": "773-621-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3166 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573133",
            "telephone_number": "773-621-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERETTE",
        "first_name": "PHILIP",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2018-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015958",
            "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 Feb 3, 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.