Theresa Krueger De Carli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.019573 Issued in IL

Practice address

7500 W Jonquil Ter
Niles, IL 60714-3106

Phone

(847) 922-9616

NPI assigned

Jan 13, 2018

Last updated

Jan 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515801600000",
    "number": "1629586508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 W JONQUIL TER",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143106",
            "telephone_number": "847-922-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 W JONQUIL TER",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143106",
            "telephone_number": "847-922-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CARLI",
        "first_name": "THERESA",
        "middle_name": "KRUEGER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-13",
        "last_updated": "2018-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.019573",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Lovino De Alba, PT
• Christina Defilippis, LCSW
• Alison M. Delacruz, APN-CNP
• Deliverance Home Health Care, Inc.
• Dental Magic of Niles
• Dental Magic Touhy, Inc (Dental Magic)

• Clinical Social Worker in Niles, IL
• Providers in Niles, 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 Jan 13, 2018; 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.