Individual provider Active NPI

Eva Gadomski, LCSW

  • Clinical Social Worker
  • Wheaton, IL
National Provider Identifier
1558604439
Registry record updated Mar 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015701 Issued in IL
Practice address
222 E Willow Ave
Wheaton, IL 60187-5426
Phone
(630) 784-4807
Fax
(630) 682-5276
NPI assigned
Mar 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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 149.015701 IL Primary

Addresses

Primary practice location

222 E Willow Ave
Wheaton, IL 60187-5426

Mailing address

222 E Willow Ave
Wheaton, IL 60187-5426
Phone (630) 784-4807

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
149.015701ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1558604439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E WILLOW AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875426",
            "telephone_number": "630-784-4807",
            "fax_number": "630-682-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E WILLOW AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875426",
            "telephone_number": "630-784-4807",
            "fax_number": "630-682-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADOMSKI",
        "first_name": "EVA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.