Individual provider Active NPI

Rachel Kovacic

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1518655224
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
150.105994 Issued in IL
Practice address
1950 N Damen Ave
Chicago, IL 60647-4565
Phone
(312) 806-2140
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
Yes

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
150.105994ILMDClinical Social Worker

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 150.105994 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1950 N Damen Ave
Chicago, IL 60647-4565

Mailing address

2334 W Belden Ave Apt 1
Chicago, IL 60647-2475
Phone (224) 392-9181

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 1, 2023.

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1518655224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 W BELDEN AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472475",
            "telephone_number": "224-392-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474565",
            "telephone_number": "312-806-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIC",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150.105994",
            "primary": true
        }
    ],
    "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 May 1, 2023; 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.