Organization Active NPI

School District 64 Park Ridge/Niles, Il

  • School Social Worker
  • Park Ridge, IL
National Provider Identifier
1689810046
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
150005062 Issued in IL
Legal business name
SCHOOL DISTRICT 64 PARK RIDGE/NILES, IL
Practice address
1731 Pavilion Way Unit 207
#207
Park Ridge, IL 60068-1190
Phone
(847) 899-8284
NPI assigned
Jan 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Dr. Victoria Mogil, PHD IN EDUCATION
Title
Principal of Emerson Middle School
Phone
(847) 318-8110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X 150005062 IL Primary

Addresses

Primary practice location

1731 Pavilion Way Unit 207
#207
Park Ridge, IL 60068-1190

Mailing address

8101 N Cumberland Ave
Niles, IL 60714-2736
Phone (847) 318-8713

Other identifiers 1

IdentifierTypeStateIssuer
150005062OtherILSTATE OF ILLINOIS DEPT. OF REGISTRATION SOCIAL WORK

National Provider Directory

National Provider Directory

Locations

8101 N Cumberland Ave
Niles, IL 60714

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1689810046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 N CUMBERLAND AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607142736",
            "telephone_number": "847-318-8713",
            "fax_number": "847-318-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 PAVILION WAY UNIT 207",
            "address_2": "#207",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681190",
            "telephone_number": "847-899-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOOL DISTRICT 64 PARK RIDGE/NILES, IL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "MOGIL",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRINCIPAL OF EMERSON MIDDLE SCHOOL",
        "authorized_official_telephone_number": "18473188110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD IN EDUCATION"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "150005062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS DEPT. OF REGISTRATION  SOCIAL WORK",
            "identifier": "150005062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.