Vicki L. Goodwin, RN, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.012290 Issued in IL

Practice address

4636 N Ravenswood Ave
Suite 201
Chicago, IL 60640-4581

Phone

(847) 422-3565

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Theodore Handrup MD LTD

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1235152687
  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1649464199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5919 CHURCH ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532473",
            "telephone_number": "847-422-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 N RAVENSWOOD AVE",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404581",
            "telephone_number": "847-422-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "VICKI",
        "middle_name": "L.",
        "credential": "RN, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "041-187397",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Goodwin
• Madeline Marie Goodwin
• Ray Goodwin, APRN, CNP
• Scott R. Goodwin, M.D
• Timothy Goodwin
• David S Goodyear
• Kayla Goodyear
• Zhen Gooi
• Aden Goolsbee
• Charles Goolsby, PHD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.