Leo W Lavender

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149017079 Issued in IL

Practice address

13811 Western Ave
Blue Island, IL 60406-3228

Phone

(773) 552-4120

NPI assigned

May 20, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Forest Psychological ServiceGroup PAC ID 6507762580, shared by 2 NPIs, 7 clinicians

Christian Community Health CenterGroup PAC ID 4284533183, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leo.lavender.1@14868.direct.athenahealth.com

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.

• Christian Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1790888238

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832

  Single Specialty

  Medicare reassignment NPD
• Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
  • NPI 1225209414
  Medicare reassignment NPD
• Oak Forest Psychological Service

  • Clinical Psychologist
  • Countryside, IL
  • NPI 1265487060
  Medicare reassignment NPD
• Fitness Clinic Wellness

  • Physical Therapist
  • Jackson, MS
  • NPI 1912352022

  IL, Single Specialty

  Medicare reassignment NPD
• I Can Hear U Now Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Blue Island, IL
  • NPI 1457237927
  NPD Authorized official
• Christian Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lansing, IL
  • NPI 1750619680
  NPD
• Christian Community Health Center

  • Federally Qualified Health Center (FQHC)
  • South Holland, IL
  • NPI 1912170457
  NPD
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Single Specialty

  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1609255819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15912 VINE AVE",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604265036",
            "telephone_number": "773-552-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13811 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604063228",
            "telephone_number": "773-552-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "LEO",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel R Kowalzyk, DO
• Kathryn K Kunz, RDLDN
• Jehan Kuri
• Elissa Kurz
• Brenda Lee Langford, MSN, APRN, FNP-C
• Carrie L Lewis, CNA
• Christel Lewis
• Lifehouse Behavioral Health, LLC
• Lifehouse Bridge Group, LLC
• Lifehouse Group, LLC

• Clinical Social Worker in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.