Active NPI
Sydney Rebecca Grant, LCSW
- Social Worker
- Chicago, IL
National Provider Identifier
1508474354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 149.022653
- Practice address
- 1319 W Fargo Ave Apt 1N
Chicago, IL 60626-1855 - Phone
- (312) 248-2206
- NPI assigned
- Jul 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 149.022653 | IL | Primary |
| Social Worker | 104100000X | 150.103804 |
Addresses
Primary practice location
1319 W Fargo Ave Apt 1N
Chicago, IL 60626-1855
Mailing address
4342 N Kenmore Ave Apt B
Chicago, IL 60613-1361
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.022653 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyas Landing, Inc. | Social Worker | Past | Accepting new patients |
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": "1594944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734739200000",
"number": "1508474354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4342 N KENMORE AVE APT B",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 W FARGO AVE APT 1N",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606261855",
"telephone_number": "312-248-2206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "SYDNEY",
"middle_name": "REBECCA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-17",
"last_updated": "2024-12-21",
"certification_date": "2024-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "149.022653",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "150.103804",
"primary": false
}
],
"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 Dec 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.