Elizabeth Deitemyer

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026162 Issued in IL

Practice address

2501 Chatham Rd
Springfield, IL 62704-4188

Phone

(312) 529-0679

NPI assigned

Aug 17, 2019

Last updated

Mar 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Open Eyes Open Heart Psychotherapy PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1568202836
  NPD Authorized official

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

{
    "created_epoch": "1566000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1679129365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 W CATALPA AVE APT 1C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606256708",
            "telephone_number": "630-863-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "312-529-0679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1127 N Oakley Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606223507",
            "country_code": "US",
            "telephone_number": "312-770-2317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEITEMYER",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-17",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026162",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yara Deeb, MD
• Kenneth Gene Deeke, RPH
• Chad Joseph Defrain, MD
• Quinlan Mae Degroot, FNP-BC
• Keelan C. Dehart, NNP-BC
• Marc R. Dejong, MD
• Jonathan E. Dela Cruz, M.D.
• Marthe K.P. Dela Cruz, M.D.
• Olivia Ann Delay, FNP-C
• Diane Deleonardo, LCSW

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.