Individual provider Active NPI

Michael R. Stellman, LCSW

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1659371649
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R021790 Issued in NY
Practice address
9655 Woods Dr Unit 1402
Skokie, IL 60077-4430
Phone
(914) 844-7177
Fax
(221) 251-8448
NPI assigned
Jul 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 R021790 NY Primary

Addresses

Primary practice location

9655 Woods Dr Unit 1402
Skokie, IL 60077-4430

Mailing address

9655 Woods Dr Unit 1402
Skokie, IL 60077-4430
Phone (914) 844-7177

Other identifiers 1

IdentifierTypeStateIssuer
0072956OtherNYGHI-BMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120214000003 NY Practitioner - Clinical Social Worker 5597922955 Practice locations: Rye Brook, NY
I20240126001595 IL Practitioner - Clinical Social Worker 5597922955 Practice locations: Skokie, IL

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

Practice addresses (Care Compare)

9655 Woods Dr
Unit 1402
Skokie, IL 60077-4430
Phone (914) 844-7177

9655 Woods Dr Unit
Suite 1402
Skokie, IL 60077-4430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R021790NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1122768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1659371649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9655 WOODS DR UNIT 1402",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774430",
            "telephone_number": "914-844-7177",
            "fax_number": "224-251-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9655 WOODS DR UNIT 1402",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774430",
            "telephone_number": "914-844-7177",
            "fax_number": "221-251-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLMAN",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-31",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R021790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-BMP",
            "identifier": "0072956",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.