Active NPI
Christina L. Linboom, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1629136882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.013328
- Practice address
- 6501 S Promontory Dr
Chicago, IL 60649-1002 - Phone
- (773) 753-8642
- Fax
- (773) 247-2188
- NPI assigned
- Dec 4, 2006
- 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 | |||
| Clinical Social Worker | 1041C0700X | 149.013328 | IL | Primary |
Addresses
Primary practice location
6501 S Promontory Dr
Chicago, IL 60649-1002
Mailing address
6501 S Promontory Dr
Chicago, IL 60649-1002
Phone (773) 753-8642
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149.013328 | Other | IL | IL DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION- SOCIAL WORK BOARD |
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 |
|---|---|---|---|
| 149.013328 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sinnissippi Centers, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rochelle, IL
- NPI 1407143837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1629136882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 S PROMONTORY DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606491002",
"telephone_number": "773-753-8642",
"fax_number": "773-247-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 S PROMONTORY DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606491002",
"telephone_number": "773-753-8642",
"fax_number": "773-247-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINBOOM",
"first_name": "CHRISTINA",
"middle_name": "L.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.013328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION- SOCIAL WORK BOARD",
"identifier": "149.013328",
"state": "IL"
}
],
"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 Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.