Individual provider Active NPI

Luiz Carlos Barbosa

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1598492183
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1723 Howard St
Evanston, IL 60202-3735
Phone
(224) 307-8550
NPI assigned
Aug 3, 2022
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.011500 IL
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

1723 Howard St
Evanston, IL 60202-3735

Mailing address

5855 N Glenwood Ave Apt 2N
Chicago, IL 60660-5421
Phone (312) 536-9845

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
I20221128001357 IL Practitioner - Clinical Social Worker 3173991072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

1555 W Howard St
Rogers Park Health Center
Chicago, IL 60626-1707
Phone (773) 764-7146

1723 Howard St
Evanston, IL 60202-3735
Phone (224) 307-8550

6020 W Diversey Ave
BLDG West
Chicago, IL 60639-1108
Phone (773) 237-5544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011500ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Nov 14, 2022 Accepting new patients
Access Community Health Network CurrentSince Nov 14, 2022 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

1723 Howard St
Evanston, IL 60202
Phone (224) 307-8550

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1598492183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 N GLENWOOD AVE APT 2N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606605421",
            "telephone_number": "312-536-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 HOWARD ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023735",
            "telephone_number": "224-307-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "LUIZ",
        "middle_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.