Individual provider Active NPI

Susan A Schaffer, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1619236031
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009022 Issued in IL
Practice address
601 Skokie Blvd Ste 207
Northbrook, IL 60062-2818
Phone
(847) 217-6871
Fax
(224) 306-2318
NPI assigned
May 4, 2012
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 149009022 IL Primary

Addresses

Primary practice location

601 Skokie Blvd Ste 207
Northbrook, IL 60062-2818

Mailing address

601 Skokie Blvd Ste 207
Northbrook, IL 60062-2818
Phone (847) 217-6871

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
I20241028003867 IL Practitioner - Clinical Social Worker 1658804752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

601 Skokie Blvd
Suite 207
Northbrook, IL 60062-2818
Phone (224) 208-5198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Susan a Schaffer LCSW, Inc. CurrentSince Jul 28, 2024 Accepting new patients

Locations

601 Skokie Blvd
Ste 207
Northbrook, IL 60062
Phone (224) 208-5198

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1619236031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SKOKIE BLVD STE 207",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622818",
            "telephone_number": "847-217-6871",
            "fax_number": "224-306-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SKOKIE BLVD STE 207",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622818",
            "telephone_number": "847-217-6871",
            "fax_number": "224-306-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.