Individual provider Active NPI

Charles Ruiz

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1487526067
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.030239 Issued in IL
Practice address
122 S Michigan Ave Ste 1441
Chicago, IL 60603-6173
Phone
(773) 820-7334
NPI assigned
Sep 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 149.030239 IL Primary

Addresses

Primary practice location

122 S Michigan Ave Ste 1441
Chicago, IL 60603-6173

Mailing address

2642 N Mildred Ave Apt 2
Chicago, IL 60614-6835
Phone (248) 842-8059

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
149.030239ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1487526067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2642 N MILDRED AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146835",
            "telephone_number": "248-842-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE STE 1441",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036173",
            "telephone_number": "773-820-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.030239",
            "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 Sep 22, 2025; 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.