Individual provider Active NPI

Jacqueline Machamer, LCSW

  • Clinical Social Worker
  • McHenry, IL
National Provider Identifier
1528615366
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024753 Issued in IL
Practice address
4209 W Shamrock LN Unit C
McHenry, IL 60050-8700
Phone
(224) 595-0835
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 149.024753 IL Primary

Addresses

Primary practice location

4209 W Shamrock LN Unit C
McHenry, IL 60050-8700

Mailing address

4209 W Shamrock LN Unit C
McHenry, IL 60050-8700

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
I20240820000553 IL Practitioner - Clinical Social Worker 9537607734 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

1512 Artaius Pkwy
Suite 102
Libertyville, IL 60048-5231
Phone (847) 847-2230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.024753ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Aug 5, 2024 Accepting new patients
Whispering Tides Therapy, PLLC Clinical Current Accepting new patients

Locations

135 N Arlington Heights Rd
Ste 105
Buffalo Grove, IL 60089
Phone (847) 291-8810

1512 Artaius Pkwy
Ste 102
Libertyville, IL 60048
Phone (847) 847-2230

1211 W 22nd St
Ste 406
Oak Brook, IL 60523

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

Interoperability endpoints

  • Direct secure messaging: jacqueline.machamer.1@25899.direct.athenahealth.com

Organizations & group practices 4

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1528615366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 W SHAMROCK LN UNIT C",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 W SHAMROCK LN UNIT C",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508700",
            "telephone_number": "224-595-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHAMER",
        "first_name": "JACQUELINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2023-04-21",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.