Individual provider Active NPI

Staci Dicristofano

  • Social Worker
  • Orland Park, IL
National Provider Identifier
1487462099
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.115805 Issued in IL
Practice address
10660 W 143Rd St
Orland Park, IL 60462-1982
Phone
(815) 258-0950
NPI assigned
Dec 28, 2024
Last updated
Dec 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.115805 IL Primary

Addresses

Primary practice location

10660 W 143Rd St
Orland Park, IL 60462-1982

Mailing address

10660 W 143Rd St
Orland Park, IL 60462-1982
Phone (815) 258-0950

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
150.115805ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1735344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1487462099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621982",
            "telephone_number": "815-258-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10660 W 143RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621982",
            "telephone_number": "815-258-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICRISTOFANO",
        "first_name": "STACI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-28",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.115805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; 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.