Individual provider Active NPI

Jessica Bowen, MSW, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1548794191
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017104 Issued in IL
Practice address
2000 N Racine Ave
3300
Chicago, IL 60614-4045
Phone
(312) 256-5874
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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 149.017104 IL Primary

Addresses

Primary practice location

2000 N Racine Ave
3300
Chicago, IL 60614-4045

Mailing address

625 W Madison St
2413
Chicago, IL 60661-2713
Phone (312) 256-5874

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017104ILMDClinical Social Worker
7224TNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1548794191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W MADISON ST",
            "address_2": "2413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612713",
            "telephone_number": "312-256-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE",
            "address_2": "3300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144045",
            "telephone_number": "312-256-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017104",
            "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 Apr 19, 2017; 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.