Individual provider Active NPI

Vanessa Gomez, LCSW

  • Clinical Social Worker
  • Gurnee, IL
National Provider Identifier
1508669961
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.029010 Issued in IL
Practice address
135 N Greenleaf St Ste 120
Gurnee, IL 60031-3334
Phone
(224) 285-0728
NPI assigned
Mar 31, 2025
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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 149.029010 IL Primary

Addresses

Primary practice location

135 N Greenleaf St Ste 120
Gurnee, IL 60031-3334

Mailing address

1104 Palmer PL
Waukegan, IL 60085-2050
Phone (224) 619-9173

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
I20250605001304 IL Practitioner - Clinical Social Worker 9931618345 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
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

2222 Audrey Nixon Blvd
Waukegan, IL 60085-7708
Phone (847) 249-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.029010ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tabularasa Integrative Health Inc CurrentSince Apr 6, 2025 Accepting new patients
CMC Healthcare LLC CurrentSince Apr 29, 2025 Accepting new patients

Locations

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

135 N Greenleaf St
Ste 120
Gurnee, IL 60031
Phone (224) 285-0728

Organizations & group practices 2

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1508669961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 PALMER PL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852050",
            "telephone_number": "224-619-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N GREENLEAF ST STE 120",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313334",
            "telephone_number": "224-285-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "VANESSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.029010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.