Individual provider Active NPI

Adrianna T Domanico Jalovec, LCSW, MBA, PMH-C

  • Clinical Social Worker
  • Arlington Heights, IL
National Provider Identifier
1497443451
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.025390 Issued in IL
Practice address
3250 N Arlington Heights Rd Unit 300
Arlington Heights, IL 60004-1500
Phone
(847) 934-7969
NPI assigned
Apr 27, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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 149.025390 IL Primary

Addresses

Primary practice location

3250 N Arlington Heights Rd Unit 300
Arlington Heights, IL 60004-1500

Mailing address

442 S Craig PL
Lombard, IL 60148-2712
Phone (630) 202-7267

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
I20230728001756 IL Practitioner - Clinical Social Worker 3779944343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
149.025390ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County CurrentSince Jul 13, 2023 Accepting new patients
Cook County CurrentSince Jul 13, 2023 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1497443451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 S CRAIG PL",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482712",
            "telephone_number": "630-202-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 N ARLINGTON HEIGHTS RD UNIT 300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041500",
            "telephone_number": "847-934-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMANICO JALOVEC",
        "first_name": "ADRIANNA",
        "middle_name": "T",
        "credential": "LCSW, MBA, PMH-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.