Samuel Adeoye, LSW
Individual provider Active NPI Social Worker · Chicago, IL
NPI 1558031476 · NPPES record last updated Sep 14, 2021
Key facts
- NPI
- 1558031476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 150.104124 (IL)
- Practice address
- 4009 N Broadway St
Chicago, IL 60613-2110 - Phone
- (773) 388-1600
- Fax
- (773) 388-8936
- NPI assigned
- Sep 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Brown Health Center | Past | Accepting new patients | |
| Howard Brown Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.104124 | IL | Yes |
Addresses
Primary practice location
4009 N Broadway St
Chicago, IL 60613-2110
Mailing address
4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150.104124 | Medicaid | IL |
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.