Organization Active NPI

Pranajaya

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1639627318
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015827 Issued in IL
Legal business name
PRANAJAYA
Practice address
5115 N Ravenswood Ave
Second Floor
Chicago, IL 60640-2712
Phone
(773) 271-7909
NPI assigned
Sep 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Authorized official

Name
Ron Pajak
Title
Director
Phone
(773) 271-7909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149015827 IL Primary

Addresses

Primary practice location

5115 N Ravenswood Ave
Second Floor
Chicago, IL 60640-2712

Mailing address

5115 N Ravenswood Ave
Second Floor
Chicago, IL 60640-2712
Phone (773) 271-7909

National Provider Directory

National Provider Directory

Locations

5115 N Ravenswood Ave
Fl Second
Chicago, IL 60640
Phone (773) 230-5109

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1639627318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N RAVENSWOOD AVE",
            "address_2": "SECOND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402712",
            "telephone_number": "773-271-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N RAVENSWOOD AVE",
            "address_2": "SECOND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402712",
            "telephone_number": "773-271-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANAJAYA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "PAJAK",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-271-7909"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015827",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 12, 2016; 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.