Active NPI
Madonna Elizabeth Gannon, LCSW
- Clinical Social Worker
- Aurora, IL
National Provider Identifier
1568583243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149011094
- Practice address
- 70 S River St
Aurora, IL 60506-5295 - Phone
- (630) 844-2662
- Fax
- (630) 844-3084
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149011094 | IL | Primary |
Addresses
Primary practice location
70 S River St
Aurora, IL 60506-5295
Mailing address
836 S Julian St
Naperville, IL 60540-6714
Phone (630) 355-4608
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Family Services | Past | Accepting new patients | |
| Metropolitan Family Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1841460391
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1992767032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236643200000",
"number": "1568583243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "836 S JULIAN ST",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605406714",
"telephone_number": "630-355-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 S RIVER ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605065295",
"telephone_number": "630-844-2662",
"fax_number": "630-844-3084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "MADONNA",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2009-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149011094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.