Individual provider Active NPI

Jerri Anne Ganz, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1689392359
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-01093 Issued in IL
Practice address
333 N Michigan Ave Ste 1400
Chicago, IL 60601-4011
Phone
(708) 415-2882
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-010935 IL
Clinical Social Worker 1041C0700X 149010935 IL
Clinical Social Worker 1041C0700X 149-01093 IL Primary

Addresses

Primary practice location

333 N Michigan Ave Ste 1400
Chicago, IL 60601-4011

Mailing address

333 N Michigan Ave Ste 1400
Chicago, IL 60601-4011
Phone (708) 415-2882

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
I20221007001043 IL Practitioner - Clinical Social Worker 5193101517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-01093ILMDClinical Social Worker
149-010935ILMDClinical Social Worker
149010935ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC Clinical CurrentSince Oct 10, 2022 Accepting new patients

Locations

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

Organizations & group practices 1

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1689392359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014011",
            "telephone_number": "708-415-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014011",
            "telephone_number": "708-415-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANZ",
        "first_name": "JERRI",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-010935",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010935",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-01093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.