Active NPI
Jennifer Ann Martin, MSW, LSW
- Social Worker
- Downers Grove, IL
National Provider Identifier
1629643648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150104615
- Practice address
- 5010 Fairview Ave Ste 5
Downers Grove, IL 60515-5201 - Phone
- (630) 869-0149
- NPI assigned
- May 21, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150104615 | IL | Primary |
Addresses
Primary practice location
5010 Fairview Ave Ste 5
Downers Grove, IL 60515-5201
Mailing address
1188 Royal Glen Dr Apt 119B
Glen Ellyn, IL 60137-6005
Phone (630) 302-8970
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150104615 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1629643648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1188 ROYAL GLEN DR APT 119B",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601376005",
"telephone_number": "630-302-8970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5010 FAIRVIEW AVE STE 5",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155201",
"telephone_number": "630-869-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-21",
"last_updated": "2021-05-21",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150104615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
- Marshal Medical Group PLLC
- Azizi Marshall, LCPC
- Martha P Jaimes Dentistry Professional Corp. (Integral Family Dental)
- Martha P Jaimes Dentistry Professional Corp.
- Altrovise Martin, PMHNP
- Monica K Martin, MD
- Gina Marie Martinelli, PMHNP-BC
- John Martucci, M.D.
- Elizabeth J Maruyama, OTR L
- Steven J. Mash, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.