Shamim A Sufi, M.A , LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3033 W Jefferson St
Suite 207
Joliet, IL 60435-5261

Phone

(630) 935-2787

Fax

(639) 922-8509

NPI assigned

Feb 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Midwest Psychiatry Associates SC

  • Psychiatry Physician
  • Forest Park, IL
  • NPI 1356432967
  NPD (past)
• Pea Inc

  dba General Psychiatry Services

  • Psychiatry Physician
  • Aurora, IL
  • NPI 1831218775
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659408003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 CONAN DOYLE RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644106",
            "telephone_number": "630-904-1637",
            "fax_number": "630-922-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W JEFFERSON ST",
            "address_2": "SUITE 207",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355261",
            "telephone_number": "630-935-2787",
            "fax_number": "639-922-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFI",
        "first_name": "SHAMIM",
        "middle_name": "A",
        "credential": "M.A , LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EARLY INTERVENTION PROVID",
            "identifier": "SS70450102P",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Stubler
• Heidi Suzanne Stukel, LCPC
• Suburban Gynecology, LLC
• Suburban Sleep and Pulmonary Medicine, SC
• Payal Sud, LCSW
• Sugni Sukhani, M.D.
• Melissa Anne Sullivan, LCSW
• Jazmin Octavia Summerise, BS, MS.
• Iisha Summers
• Summit Center for Mental Health Inc

• Clinical Social Worker in Joliet, IL
• Providers in Joliet, 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 Jul 8, 2007; 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.