Individual provider Active NPI

Yukako Ishiguro Sortino, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1649047036
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149026091 Issued in IL
Practice address
4009 N Broadway St
Chicago, IL 60613-2110
Phone
(773) 275-2586
NPI assigned
Dec 6, 2023
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 149026091 IL Primary

Addresses

Primary practice location

4009 N Broadway St
Chicago, IL 60613-2110

Mailing address

5311 S Harper Ave Apt 3
Chicago, IL 60615-4686
Phone (630) 386-5317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149026091ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Alliance Health CurrentSince Jul 7, 2024 Accepting new patients
Heartland Alliance Health Current Accepting new patients
Heartland Alliance Health CurrentSince Jul 7, 2024 Accepting new patients

Locations

4009 N Broadway St
Chicago, IL 60613
Phone (773) 275-2586

5501 S Halsted St
Chicago, IL 60621
Phone (773) 220-8562

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, 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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1649047036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 S HARPER AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154686",
            "telephone_number": "630-386-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132110",
            "telephone_number": "773-275-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORTINO",
        "first_name": "YUKAKO",
        "middle_name": "ISHIGURO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149026091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.