Individual provider Active NPI

Todd Lazar

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1639664873
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018280
Practice address
2858 W Diversey Ave
Chicago, IL 60647-1871
Phone
(312) 925-6366
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 149018280 Primary

Addresses

Primary practice location

2858 W Diversey Ave
Chicago, IL 60647-1871

Mailing address

2637 N Whipple St
Chicago, IL 60647-1721

Other practice location 1

455 E Main St
East Dundee, IL 60118-1529
Phone (872) 242-7540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219002198 IL Practitioner - Clinical Social Worker 3971848961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3020 N Kimball Ave
Chicago, IL 60618-6812
Phone (773) 484-7948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patterns and Threads Psychotherapy & Consultation PLLC CurrentSince Jun 30, 2020 Accepting new patients
Todd Lazar LCSW LLC CurrentSince Feb 9, 2020 Accepting new patients
Guiding Behavior Counseling, PLLC Clinical PastSince Jun 30, 2020 Accepting new patients

Locations

3020 N Kimball Ave
Chicago, IL 60618
Phone (312) 317-9308

2858 W Diversey Ave
Chicago, IL 60647
Phone (312) 374-6621

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1639664873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 N WHIPPLE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2858 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471871",
            "telephone_number": "312-925-6366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 E Main St",
            "address_purpose": "LOCATION",
            "city": "East Dundee",
            "state": "IL",
            "postal_code": "601181529",
            "country_code": "US",
            "telephone_number": "872-242-7540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "TODD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "149018280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.