Individual provider Active NPI

Michael Heard, LCSW

  • Clinical Social Worker
  • Antioch, IL
National Provider Identifier
1649447939
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149006014 Issued in IL
Practice address
800 Main St Ste 210
Antioch, IL 60002-1578
Phone
(847) 903-5604
NPI assigned
May 15, 2008
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149006014 IL
Clinical Social Worker 1041C0700X 149006014 IL Primary

Addresses

Primary practice location

800 Main St Ste 210
Antioch, IL 60002-1578

Mailing address

925 Killarney Dr
Dyer, IN 46311-1292
Phone (773) 618-2231

Other practice location 1

925 Killarney Dr
Dyer, IN 46311-1292
Phone (773) 618-2231

Other names 1

  • Michael Heard Professional 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
I20160420001302 IL Practitioner - Clinical Social Worker 5698073997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

654 E 47TH St
Chicago, IL 60653-4224
Phone (773) 624-4800

8234 S Ashland Ave
Auburn Gresham Family Health Center
Chicago, IL 60620-4625
Phone (773) 874-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149006014ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Current Accepting new patients
Access Community Health Network CurrentSince Mar 11, 2019 Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince Mar 19, 2016 Accepting new patients
Access Community Health Network CurrentSince Mar 11, 2019 Accepting new patients
Mount Sinai Community Foundation CurrentSince Mar 19, 2016 Accepting new patients
Access Community Health Network Current Accepting new patients
C.L.O. Psychological, Serv. Past Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

8234 S Ashland Ave
Chicago, IL 60620
Phone (773) 874-1400

Organizations & group practices 7

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1649447939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 KILLARNEY DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111292",
            "telephone_number": "773-618-2231",
            "fax_number": "219-865-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST STE 210",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021578",
            "telephone_number": "847-903-5604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Killarney Dr",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "IN",
            "postal_code": "463111292",
            "country_code": "US",
            "telephone_number": "773-618-2231",
            "fax_number": "219-865-7879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEARD",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149006014",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149006014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "HEARD",
            "credential": "M.A.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.