Individual provider Active NPI

Ann Clark Schulz, LCSW

  • Clinical Social Worker
  • Burr Ridge, IL
National Provider Identifier
1689813792
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.009613 Issued in IL
Practice address
200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953
Phone
(630) 423-5998
Fax
(630) 537-1241
NPI assigned
Feb 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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 149.009613 IL Primary

Addresses

Primary practice location

200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953

Mailing address

200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953
Phone (630) 423-5998

Other identifiers 1

IdentifierTypeStateIssuer
04515143OtherILBCBS#

Other names 1

  • Ann Clark Shields Former name

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
I20090901000181 IL Practitioner - Clinical Social Worker 0244385094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Restoring Wellness Clinical Services PLLCGroup PAC ID 3274954722, 7 clinicians

Practice addresses (Care Compare)

200 S Frontage Rd
Suite 320
Burr Ridge, IL 60527-6953
Phone (630) 423-5998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.009613ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Wellness Clinical Services, PLLC Clinical CurrentSince Aug 1, 2023 Accepting new patients

Locations

200 S Frontage Rd
Ste 320
Burr Ridge, IL 60527
Phone (630) 337-8006

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": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1689813792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S FRONTAGE RD STE 320",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276953",
            "telephone_number": "630-423-5998",
            "fax_number": "630-537-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S FRONTAGE RD STE 320",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276953",
            "telephone_number": "630-423-5998",
            "fax_number": "630-537-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZ",
        "first_name": "ANN",
        "middle_name": "CLARK",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.009613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS#",
            "identifier": "04515143",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "SHIELDS",
            "middle_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.