Individual provider Active NPI

Sharon Bastin, LCSW

  • Clinical Social Worker
  • Willowbrook, IL
National Provider Identifier
1639417090
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016411 Issued in IL
Practice address
545 Plainfield Rd Ste C
Willowbrook, IL 60527-7601
Phone
(773) 991-6582
NPI assigned
Jan 19, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.016411 IL Primary

Addresses

Primary practice location

545 Plainfield Rd Ste C
Willowbrook, IL 60527-7601

Mailing address

545 Plainfield Rd Ste C
Willowbrook, IL 60527-7601
Phone (773) 991-6582

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

LicenseStateTypeSpecialty
149.016411ILMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639417090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PLAINFIELD RD STE C",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605277601",
            "telephone_number": "773-991-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 PLAINFIELD RD STE C",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605277601",
            "telephone_number": "773-991-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIN",
        "first_name": "SHARON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.