NPIMap

Organization Active NPI

Soulu

Doing business as Madraigos Midwest

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1689029050
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOULU
Doing business as
Madraigos Midwest
Practice address
3557 W Peterson Ave #122
Chicago, IL 60659
Phone
(773) 478-6000
Fax
(773) 478-6516
NPI assigned
May 4, 2016
Last updated
May 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Jay Greenberger, LCSW
Title
Clinical Director
Phone
(773) 478-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Voluntary or Charitable Agency 251V00000X

Addresses

Primary practice location

3557 W Peterson Ave #122
Chicago, IL 60659

Mailing address

3557 W Peterson Ave #122
Chicago, IL 60659
Phone (773) 478-6000

Other names 1

  • Madraigos Midwest Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Madraigos Midwest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

  • Soulu

    dba Upward Community

    • Adolescent and Children Mental Health Clinic/Center
    • Lincolnwood, IL
    • NPI 1538057609
    NPD tax ID

Locations

3557 W Peterson Ave
Ste 122
Chicago, IL 60659
Phone (773) 478-6000

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1689029050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 W PETERSON AVE #122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-478-6000",
            "fax_number": "773-478-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3557 W PETERSON AVE #122",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-478-6000",
            "fax_number": "773-478-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULU",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "GREENBERGER",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "773-478-6000",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madraigos Midwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 4, 2016; 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.