Active NPI
Jamal S. Jailawi, MSW
- Clinical Social Worker
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149017779
- Practice address
- 820 S Damen Ave
4210
Chicago, IL 60612-3728 - Phone
- (312) 569-6031
- Fax
- (312) 569-6171
- NPI assigned
- Nov 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149017779 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
4210
Chicago, IL 60612-3728
Mailing address
2700 Patriot Blvd 250
Glenview, IL 60026-8021
Phone (312) 756-0468
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1512 NW Fargo Ave
Chicago, IL 60626-1805
Phone (773) 465-7751
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149017779 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Clinical | Current | Accepting new patients |
Locations
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
1512 W Fargo Ave
Chicago, IL 60626
Phone (773) 465-7751
7433 N Clark St
Chicago, IL 60626
Phone (312) 756-0468
3450 Oakton St
Ste 300
Skokie, IL 60076
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1487930673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 PATRIOT BLVD 250",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268021",
"telephone_number": "312-756-0468",
"fax_number": "847-324-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"address_2": "4210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-6031",
"fax_number": "312-569-6171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAILAWI",
"first_name": "JAMAL",
"middle_name": "S.",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-01",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149017779",
"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 Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.