Juan Carbajal – Social Worker in Woodstock, IL

Key facts

NPI: 1699110650
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
Practice address: 101 S Jefferson St
Woodstock, IL 60098-3437
Phone: (815) 338-7360
NPI assigned: May 5, 2013
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker	104100000X			Yes

Addresses

Primary practice location

101 S Jefferson St
Woodstock, IL 60098-3437

Mailing address

101 S Jefferson St
Woodstock, IL 60098-3437
Phone (815) 338-7360

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 5, 2013.

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367712000000",
    "number": "1699110650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S JEFFERSON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983437",
            "telephone_number": "815-338-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S JEFFERSON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983437",
            "telephone_number": "815-338-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-05",
        "last_updated": "2013-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

All providers in Woodstock, IL · Social Worker in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.