Individual provider Active NPI

Thetis Rachel Cromie, PH.D.

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1558426296
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008115 Issued in IL
Practice address
122 S Michigan Ave
Suite 1459
Chicago, IL 60603-6191
Phone
(312) 922-1025
NPI assigned
Dec 22, 2006
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 149008115 IL Primary

Addresses

Primary practice location

122 S Michigan Ave
Suite 1459
Chicago, IL 60603-6191

Mailing address

122 S Michigan Ave
Suite 1459
Chicago, IL 60603-6191
Phone (312) 922-1025

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
I20130109000059 IL Practitioner - Clinical Social Worker 4486807195 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

122 S Michigan Ave
Chicago, IL 60603-6182
Phone (312) 922-1025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1558426296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE",
            "address_2": "SUITE 1459",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-922-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE",
            "address_2": "SUITE 1459",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-922-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMIE",
        "first_name": "THETIS",
        "middle_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.