Individual provider Active NPI

Amy C Tiemersma, LCSW

  • School Social Worker
  • Palos Heights, IL
National Provider Identifier
1710048145
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
1374006 Issued in IL
Practice address
12927 South Monitor Ave
Palos Heights, IL 60463
Phone
(708) 371-0800
Fax
(708) 371-0833
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 1374006 IL Primary
Clinical Social Worker 1041C0700X IL

Addresses

Primary practice location

12927 South Monitor Ave
Palos Heights, IL 60463

Mailing address

16031 Louis Ave
South Holland, IL 60473
Phone (708) 331-1379

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149009092ILMDClinical Social Worker
1374006ILMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710048145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16031 LOUIS AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "60473",
            "telephone_number": "708-331-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12927 SOUTH MONITOR AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-371-0800",
            "fax_number": "708-371-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEMERSMA",
        "first_name": "AMY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "1374006",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.