Active NPI
Blanca Lucille Lopez
- Clinical Social Worker
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149018185
- Practice address
- 2355 S Western Ave
Chicago, IL 60608-3837 - Phone
- (773) 254-1400
- Fax
- (773) 650-1239
- NPI assigned
- Aug 4, 2011
- Sex
- Female
- Sole proprietor
- No
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 | |||
| Clinical Social Worker | 1041C0700X | 149018185 | IL | Primary |
Addresses
Primary practice location
2355 S Western Ave
Chicago, IL 60608-3837
Mailing address
966 W 21St St
Chicago, IL 60608-4511
Phone (773) 254-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3202 W N Ave
Humboldt Family Health Center
Chicago, IL 60647-4940
Phone (773) 278-1880
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients | |
| Access Community Health Network | Current | Accepting new patients |
Locations
600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000
1 N Broadway St
Des Plaines, IL 60016
Phone (847) 298-3150
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Des Plaines, IL
- NPI 1982783692
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1699701383
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1952480287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1538448865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "966 W 21ST ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606084511",
"telephone_number": "773-254-1400",
"fax_number": "773-650-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606083837",
"telephone_number": "773-254-1400",
"fax_number": "773-650-1239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "BLANCA",
"middle_name": "LUCILLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149018185",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "IL"
}
],
"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 Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.