James Novacek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009838 Issued in IL

Practice address

800 Main St Ste 210
Antioch, IL 60002-1578

Phone

(847) 903-5604

Fax

(224) 788-5112

NPI assigned

Oct 8, 2018

Last updated

Oct 8, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1609341577",
    "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": "NOVACEK",
        "first_name": "JAMES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Antioch, IL
• Providers in Antioch, 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 Oct 8, 2018; 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.