Active NPI
Jacqueline R Pangilinan, LCSW
- Clinical Social Worker
- Mundelein, IL
National Provider Identifier
1710293055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149010343
- Practice address
- 1215 Orleans Dr
Mundelein, IL 60060-4858 - Phone
- (847) 362-5483
- NPI assigned
- Aug 24, 2010
- Last updated
- Aug 24, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149010343 | IL | Primary |
Addresses
Primary practice location
1215 Orleans Dr
Mundelein, IL 60060-4858
Mailing address
1215 Orleans Dr
Mundelein, IL 60060-4858
Phone (847) 362-5483
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149010343 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1710293055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 ORLEANS DR",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600604858",
"telephone_number": "847-362-5483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 ORLEANS DR",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600604858",
"telephone_number": "847-362-5483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANGILINAN",
"first_name": "JACQUELINE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-24",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149010343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.