Individual provider Active NPI

Andrea Vallejo

  • Social Worker
  • Schaumburg, IL
National Provider Identifier
1548086473
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150114853 Issued in IL
Practice address
10 N Martingale Rd Ste 400
Schaumburg, IL 60173-2411
Phone
(847) 466-1004
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150114853 IL Primary

Addresses

Primary practice location

10 N Martingale Rd Ste 400
Schaumburg, IL 60173-2411

Mailing address

10 N Martingale Rd Ste 400
Schaumburg, IL 60173-2411
Phone (847) 466-1004

Other practice location 1

4305 N Lincoln Ave
Chicago, IL 60618-1807
Phone (847) 466-1004

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
150114853ILMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1548086473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MARTINGALE RD STE 400",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732411",
            "telephone_number": "847-466-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MARTINGALE RD STE 400",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601732411",
            "telephone_number": "847-466-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4305 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606181807",
            "country_code": "US",
            "telephone_number": "847-466-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150114853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.

Verify at the official NPI Registry.