Individual provider Active NPI

Mariana Sanchez, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1659777829
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017030 Issued in IL
Practice address
3003 W Touhy Ave
Chicago, IL 60645-2833
Phone
(773) 508-1000
Fax
(773) 508-1112
NPI assigned
Nov 14, 2014
Last updated
Nov 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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 149.017030 IL Primary

Addresses

Primary practice location

3003 W Touhy Ave
Chicago, IL 60645-2833

Mailing address

3003 W Touhy Ave
Chicago, IL 60645-2833
Phone (773) 508-1000

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
I20150106001738 IL Practitioner - Clinical Social Worker 7416270053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Council for Jewish ElderlyGroup PAC ID 8224932702, 20 clinicians

Practice addresses (Care Compare)

1551 Lake Cook Rd
Deerfield, IL 60015-5651
Phone (847) 374-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017030ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Jewish Elderly Clinical CurrentSince Apr 1, 2018 Accepting new patients

Locations

3003 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

3033 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

Organizations & group practices 1

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1659777829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452833",
            "telephone_number": "773-508-1000",
            "fax_number": "773-508-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452833",
            "telephone_number": "773-508-1000",
            "fax_number": "773-508-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "MARIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.