Individual provider Active NPI

Jamal S. Jailawi, MSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1487930673
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017779 Issued in IL
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

Updated by the provider on Jul 28, 2015

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730012804 IL Practitioner - Clinical Social Worker 7416261714 Reassigns benefits to 1 organization

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
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

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

LicenseStateTypeSpecialty
149017779ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Mar 1, 2023 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

Verify at the official NPI Registry.