Individual provider Active NPI

Cornelius Francis Gorman III, LCSW

  • Clinical Social Worker
  • Downers Grove, IL
National Provider Identifier
1669723284
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015460 Issued in IL
Practice address
1125 Franklin St
Downers Grove, IL 60515-3551
Phone
(630) 247-1978
NPI assigned
Sep 21, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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 149.015460 IL Primary

Addresses

Primary practice location

1125 Franklin St
Downers Grove, IL 60515-3551

Mailing address

1125 Franklin St
Downers Grove, IL 60515-3551
Phone (630) 247-1978

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
I20190226003497 IL Practitioner - Clinical Social Worker 0648519280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1125 Franklin St
Downers Grove, IL 60515-3551
Phone (630) 247-1978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015460ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jep Therapy LLC Clinical CurrentSince May 12, 2024 Accepting new patients
Edgewood Clinical Services, P.C. Clinical PastSince Jul 27, 2023 Accepting new patients
Samaritan Counseling Center PastSince Jan 14, 2019 Accepting new patients
Edgewood Clinical Services, P.C. Past Accepting new patients

Locations

1125 Franklin St
Downers Grove, IL 60515
Phone (630) 247-1978

1125 Franklin St
Ste 128
Downers Grove, IL 60515

Organizations & group practices 5

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": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1669723284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 FRANKLIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153551",
            "telephone_number": "630-247-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 FRANKLIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153551",
            "telephone_number": "630-247-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "CORNELIUS",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.