Individual provider Active NPI

Sonja Irene Depratt, LCSW

  • Social Worker
  • Shorewood, IL
National Provider Identifier
1487763165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
520 Rollingwood Dr
Shorewood, IL 60404
Phone
(815) 207-4438
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

520 Rollingwood Dr
Shorewood, IL 60404

Mailing address

520 Rollingwood Dr
Shorewood, IL 60404
Phone (815) 207-4438

Other identifiers 1

IdentifierTypeStateIssuer
00099Z666OtherILBLUE CROSS/BLUE SHIELD

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
149-008693ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487763165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 ROLLINGWOOD DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "60404",
            "telephone_number": "815-207-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ROLLINGWOOD DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "60404",
            "telephone_number": "815-207-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRATT",
        "first_name": "SONJA",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00099Z666",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.