Individual provider Active NPI

Karen Jeanette Ledezma, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1497402804
Registry record updated Mar 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024109 Issued in IL
Practice address
6551 North Ave
Oak Park, IL 60302-1020
Phone
(224) 442-4914
NPI assigned
Mar 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2022

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 149.024109 IL Primary

Addresses

Primary practice location

6551 North Ave
Oak Park, IL 60302-1020

Mailing address

6551 North Ave
Oak Park, IL 60302-1020
Phone (224) 442-4914

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
149.024109ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1646438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1497402804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021020",
            "telephone_number": "224-442-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021020",
            "telephone_number": "224-442-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDEZMA",
        "first_name": "KAREN",
        "middle_name": "JEANETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-05",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; 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.