Individual provider Active NPI

Shahalonie Herman

  • Clinical Social Worker
  • Machesney Park, IL
National Provider Identifier
1659724995
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149027354 Issued in IL
Practice address
1205 W Lane Rd
Machesney Park, IL 61115-1625
Phone
(815) 469-1500
NPI assigned
Jul 21, 2016
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X IL
Clinical Social Worker 1041C0700X 149027354 IL Primary

Addresses

Primary practice location

1205 W Lane Rd
Machesney Park, IL 61115-1625

Mailing address

4624 Ravine Dr
Loves Park, IL 61111-6930
Phone (815) 904-1327

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
I20250403000860 IL Practitioner - Clinical Social Worker 2567985252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Alberto Minzer and Associates LLCGroup PAC ID 1557748316, 5 clinicians

Practice addresses (Care Compare)

766 N Walden Dr
Palatine, IL 60067-8641
Phone (847) 602-8023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149027354ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alberto Minzer and Associates LLC CurrentSince Mar 1, 2025 Accepting new patients
Pioneer Center for Human Services Past Accepting new patients
Westside Childrens Therapy PastSince Mar 30, 2025 Accepting new patients

Organizations & group practices 4

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1659724995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 RAVINE DR",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611116930",
            "telephone_number": "815-904-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W LANE RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151625",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "SHAHALONIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

Verify at the official NPI Registry.