David Velez Carrillo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149000311 Issued in IL

Practice address

675 N North CT Ste 260
Palatine, IL 60067-8141

Phone

(847) 934-6290

Fax

(847) 359-5220

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629083043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N CRESCENT AVE",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600674885",
            "telephone_number": "847-934-6290",
            "fax_number": "847-359-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N NORTH CT STE 260",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678141",
            "telephone_number": "847-934-6290",
            "fax_number": "847-359-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "DAVID",
        "middle_name": "VELEZ",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149000311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Palatine, IL
• Providers in Palatine, IL by specialty
• Clinical Social Worker in Illinois

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.