Active NPI
Amanda Brooks
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1659786465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149016785
- Practice address
- 5425 W Lake St
Chicago, IL 60644-2342 - Phone
- (773) 378-3347
- Fax
- (773) 378-4028
- NPI assigned
- Jul 1, 2014
- Last updated
- Dec 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149016785 | IL | Primary |
Addresses
Primary practice location
5425 W Lake St
Chicago, IL 60644-2342
Mailing address
5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 378-3347
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1659786465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5425 W LAKE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606442342",
"telephone_number": "773-378-3347",
"fax_number": "773-378-4028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5425 W LAKE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606442342",
"telephone_number": "773-378-3347",
"fax_number": "773-378-4028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-01",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149016785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.