Individual provider Active NPI

Rebecca Fallert, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1497806004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
120 S Marion St
Oak Park, IL 60302-2809
Phone
(708) 383-7500
NPI assigned
Jan 12, 2007
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
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

120 S Marion St
Oak Park, IL 60302-2809

Mailing address

120 S Marion St
Oak Park, IL 60302-2809
Phone (708) 383-7500

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
I20110117000031 IL Practitioner - Clinical Social Worker 4981893344

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

120 S Marion St
Oak Park, IL 60302-2809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149003415ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling Center CurrentSince Aug 20, 1990 Accepting new patients

Locations

120 S Marion St
Oak Park, IL 60302
Phone (708) 383-7500

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/thrivecc/r4/

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497806004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLERT",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.