Individual provider Active NPI

Jesse L Munoz, LCSW

  • Mental Health Counselor
  • Orland Park, IL
National Provider Identifier
1649390675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
14400 John Humphrey Dr
Suite 200
Orland Park, IL 60462-2897
Phone
(708) 226-1360
NPI assigned
Mar 31, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IL Primary

Addresses

Primary practice location

14400 John Humphrey Dr
Suite 200
Orland Park, IL 60462-2897

Mailing address

14534 S Emerald Ave
Riverdale, IL 60827-2619

Other names 1

  • Jesus L Munoz Other name

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
I20050811000995 IL Practitioner - Clinical Social Worker 4082643713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Ledvora MD SCGroup PAC ID 4587898754, 7 clinicians

Practice addresses (Care Compare)

7808 W College Dr
Suite 2
Palos Heights, IL 60463-1027
Phone (708) 361-5110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149001499ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The McGrath Clinic Past Accepting new patients
The McGrath Clinic S C Mental Health PastSince Aug 2, 2004 Accepting new patients

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": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649390675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14534 S EMERALD AVE",
            "city": "RIVERDALE",
            "state": "IL",
            "postal_code": "608272619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 JOHN HUMPHREY DR",
            "address_2": "SUITE 200",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622897",
            "telephone_number": "708-226-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "JESSE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESUS",
            "last_name": "MUNOZ",
            "middle_name": "L",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.