Individual provider Active NPI

Ignacio Perez Arizmendi, LCSW

  • Clinical Social Worker
  • Berwyn, IL
National Provider Identifier
1689982829
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014304 Issued in IL
Practice address
2428 Euclid Ave
Berwyn, IL 60402-2507
Phone
(773) 807-2392
NPI assigned
Sep 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2022

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 149014304 IL Primary

Addresses

Primary practice location

2428 Euclid Ave
Berwyn, IL 60402-2507

Mailing address

2428 Euclid Ave
Berwyn, IL 60402-2507
Phone (773) 807-2392

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
I20120423000089 IL Practitioner - Clinical Social Worker 6204097041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

1701 W Superior St
Chicago, IL 60622-5646
Phone (312) 666-3494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ignacio Perez Arizmendi- LCSW, LLC Clinical CurrentSince Jul 23, 2023 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 11, 2022 Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 11, 2022 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

Organizations & group practices 4

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": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1689982829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 EUCLID AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022507",
            "telephone_number": "773-807-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 EUCLID AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022507",
            "telephone_number": "773-807-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ ARIZMENDI",
        "first_name": "IGNACIO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.