Individual provider Active NPI

Daniel Adam Gordon, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1649429242
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015415 Issued in IL
Practice address
1525 E 53Rd St Ste 1009
Chicago, IL 60615-4547
Phone
(312) 566-1702
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 149015415 IL Primary

Addresses

Primary practice location

1525 E 53Rd St Ste 1009
Chicago, IL 60615-4547

Mailing address

1525 E 53Rd St Ste 1009
Chicago, IL 60615-4547
Phone (312) 566-1702

Other practice location 1

5325 S Hyde Park Blvd
Chicago, IL 60615-5720
Phone (312) 952-8608

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
149015415ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
D Gordon & Associates LLC Clinical CurrentSince Mar 21, 2021 Accepting new patients
D. Gordon and Associates Clinical PastSince Aug 21, 2012 Accepting new patients

Locations

1525 E 53rd St
Ste 1009
Chicago, IL 60615
Phone (312) 566-1702

Organizations & group practices 2

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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1649429242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST STE 1009",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154547",
            "telephone_number": "312-566-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST STE 1009",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154547",
            "telephone_number": "312-566-1702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5325 S Hyde Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606155720",
            "country_code": "US",
            "telephone_number": "312-952-8608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DANIEL",
        "middle_name": "ADAM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.