Individual provider Active NPI

Shelia Traylor, LCSW

  • Clinical Social Worker
  • Antioch, IL
National Provider Identifier
1609338946
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
800 Main St Ste 210
Antioch, IL 60002-1578
Phone
(847) 903-5604
Fax
(224) 788-5112
NPI assigned
Apr 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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 IL Primary

Addresses

Primary practice location

800 Main St Ste 210
Antioch, IL 60002-1578

Mailing address

PO Box 856
Antioch, IL 60002-0856
Phone (847) 903-5604

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
I20190422001244 IL Practitioner - Clinical Social Worker 9638411788 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Feb 7, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1609338946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 856",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600020856",
            "telephone_number": "847-903-5604",
            "fax_number": "224-788-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST STE 210",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021578",
            "telephone_number": "847-903-5604",
            "fax_number": "224-788-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYLOR",
        "first_name": "SHELIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.