Individual provider Active NPI

Lynette Hickey, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1689706749
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
11123 S Saint Louis Ave
Chicago, IL 60655-3520
Phone
(773) 238-6331
NPI assigned
Mar 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

11123 S Saint Louis Ave
Chicago, IL 60655-3520

Mailing address

11123 S Saint Louis Ave
Chicago, IL 60655-3520
Phone (773) 238-6331

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
I20240112002116 IL Practitioner - Clinical Social Worker 7719338854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mirjam Quinn and Associates LTDGroup PAC ID 7517315914, 4 clinicians

Practice addresses (Care Compare)

10801 S Western Ave
Suite 2B
Chicago, IL 60643-3225
Phone (708) 586-7357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149006016ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mirjam Quinn and Associates, LTD CurrentSince Feb 1, 2024 Accepting new patients
Valentin Berman MD PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

10801 S Western Ave
Ste 2B
Chicago, IL 60643
Phone (708) 499-3525

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689706749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11123 S SAINT LOUIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553520",
            "telephone_number": "773-238-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11123 S SAINT LOUIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553520",
            "telephone_number": "773-238-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "LYNETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.