Individual provider Active NPI

Marge Ellen Epstein

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1619081809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1111 Westgate St
Oak Park, IL 60301-1007
Phone
(708) 848-0576
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

1111 Westgate St
Oak Park, IL 60301-1007

Mailing address

1111 Westgate St
Oak Park, IL 60301-1007
Phone (708) 848-0576

Other identifiers 1

IdentifierTypeStateIssuer
0001636159OtherILBLUE CROSS/BLUE SHIELD PP

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.003992ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619081809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011007",
            "telephone_number": "708-848-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011007",
            "telephone_number": "708-848-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "MARGE",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD PP",
            "identifier": "0001636159",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.