Individual provider Active NPI

Danielle Shannon

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1689014888
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015945 Issued in IL
Practice address
9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389
Phone
(847) 676-4447
Fax
(847) 676-4450
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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 149015945 IL Primary

Addresses

Primary practice location

9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389

Mailing address

9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389
Phone (847) 676-4447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230717001868 MI Practitioner - Clinical Social Worker 3072889872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015945ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1689014888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9239 GROSS POINT RD",
            "address_2": "SUITE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771389",
            "telephone_number": "847-676-4447",
            "fax_number": "847-676-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9239 GROSS POINT RD",
            "address_2": "SUITE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771389",
            "telephone_number": "847-676-4447",
            "fax_number": "847-676-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.