Active NPI
Bailey Shibata
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1619204088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149017373
- Practice address
- 259 E Erie St Ste 1900
Chicago, IL 60611-3246 - Phone
- (312) 695-7950
- Fax
- (312) 695-5747
- NPI assigned
- Nov 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 149017373 | IL | |
| Clinical Social Worker | 1041C0700X | 149017373 | IL | Primary |
Addresses
Primary practice location
259 E Erie St Ste 1900
Chicago, IL 60611-3246
Mailing address
259 E Erie St Ste 1900
Chicago, IL 60611-3246
Phone (312) 695-7950
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149017373 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644969600000",
"number": "1619204088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 1900",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113246",
"telephone_number": "312-695-7950",
"fax_number": "312-695-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E ERIE ST STE 1900",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606113246",
"telephone_number": "312-695-7950",
"fax_number": "312-695-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBATA",
"first_name": "BAILEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-05",
"last_updated": "2022-02-16",
"certification_date": "2022-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "149017373",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149017373",
"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 Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.