Active NPI
Carolyn Elizabeth Gehle, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1619951365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-002315
- Practice address
- 4753 N Broadway St Ste 928
Chicago, IL 60640-7911 - Phone
- (773) 472-6615
- Fax
- (847) 410-7035
- NPI assigned
- Dec 5, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149-002315 | IL | Primary |
Addresses
Primary practice location
4753 N Broadway St Ste 928
Chicago, IL 60640-7911
Mailing address
3509A Church St
Evanston, IL 60203-1603
Phone (847) 410-7035
Other practice location 1
3139 N Lincoln Ave
Suite 220
Chicago, IL 60657-3114
Phone (773) 472-6615
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040325001423 | IL | Practitioner - Clinical Social Worker | 2961394911 | Practice locations: Skokie, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Skokie, IL 60076
Phone (773) 472-6615
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149-002315 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1619951365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509A CHURCH ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602031603",
"telephone_number": "847-410-7035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4753 N BROADWAY ST STE 928",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407911",
"telephone_number": "773-472-6615",
"fax_number": "847-410-7035"
}
],
"practiceLocations": [
{
"address_1": "3139 N Lincoln Ave",
"address_2": "Suite 220",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606573114",
"country_code": "US",
"telephone_number": "773-472-6615",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GEHLE",
"first_name": "CAROLYN",
"middle_name": "ELIZABETH",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-05",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-002315",
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.