Individual provider Active NPI

Elisabeth A Purkis, MSW, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1619203288
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009869 Issued in IL
Practice address
801 S Paulina St
Chicago, IL 60612
Phone
(312) 355-0527
Fax
(312) 413-1638
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 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 149009869 IL Primary

Addresses

Primary practice location

801 S Paulina St
Chicago, IL 60612

Mailing address

801 S. Paulina St
230-CB (MC 850)
Chicago, IL 60612-7211
Phone (312) 355-0527

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
149009869ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1619203288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S. PAULINA ST",
            "address_2": "230-CB (MC 850)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127211",
            "telephone_number": "312-355-0527",
            "fax_number": "312-413-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-355-0527",
            "fax_number": "312-413-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURKIS",
        "first_name": "ELISABETH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.