Individual provider Active NPI

Bryn Slager, MSW, LSW, QMHP

  • Social Worker
  • Dixon, IL
National Provider Identifier
1669013967
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150102388 Issued in IL
Practice address
325 Il Route 2
Dixon, IL 61021-9118
Phone
(815) 284-6611
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150102388 IL Primary

Addresses

Primary practice location

325 Il Route 2
Dixon, IL 61021-9118

Mailing address

823 N Dixon Ave
Dixon, IL 61021-1617
Phone (815) 618-2706

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
I20220621000436 IL Practitioner - Clinical Social Worker 1759760838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150102388ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sinnissippi Centers, Inc. CurrentSince Mar 11, 2022 Accepting new patients
Sinnissippi Centers, Inc. Current Accepting new patients
Sinnissippi Centers, Inc. CurrentSince Mar 11, 2022 Accepting new patients

Locations

Rte 2 325 Illinois
Dixon, IL 61021

325 Il Route 2
Dixon, IL 61021
Phone (815) 288-6611

1321 N 7th St
Rochelle, IL 61068
Phone (815) 562-3801

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1669013967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 N DIXON AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211617",
            "telephone_number": "815-618-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 IL ROUTE 2",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219118",
            "telephone_number": "815-284-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAGER",
        "first_name": "BRYN",
        "credential": "MSW, LSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150102388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.