Bruce Person, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-007548 Issued in IL

Practice address

1752 Windsor Rd Ste 203
Loves Park, IL 61111-4276

Phone

(815) 986-1113

Fax

(815) 986-1119

NPI assigned

Feb 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clinic of Psychiatric Care

  • Psychiatry Physician
  • Loves Park, IL
  • NPI 1659531549
  NPD (past)
• Progressive Chiropractic Wellness & Rehab Centre, P.C.

  • Point of Service
  • Loves Park, IL
  • NPI 1023206265
  NPD (past)

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1629341219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E GATE PKWY",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086137",
            "telephone_number": "815-986-1113",
            "fax_number": "815-986-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 WINDSOR RD STE 203",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114276",
            "telephone_number": "815-986-1113",
            "fax_number": "815-986-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSON",
        "first_name": "BRUCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "149-007548",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Paluzzi, L,M.T.
• Ember Marie Pastore-Hills
• Krupa V Patel, OD
• Nassar Patni, MD
• Jeanne M Perian, RDN, LDN
• Paola Pesantes, M.D
• Darryl J. Phipps, CRNA
• Physicians Immediate Care LTD (Physicians Immediate Care)
• Asher Jr Timario Piedad, MD
• Joseph John Pingo, BCBA

• Clinical Social Worker in Loves Park, IL
• Providers in Loves Park, 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 Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.