Individual provider Active NPI

Marquise Demone Byers, LCSW

  • Clinical Social Worker
  • Olympia Fields, IL
National Provider Identifier
1710623756
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149022814 Issued in IL
Practice address
111 Graymoor LN
Olympia Fields, IL 60461-1204
Phone
(773) 603-0782
NPI assigned
May 11, 2022
Last updated
May 11, 2022By the provider in NPPES
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 149022814 IL Primary

Addresses

Primary practice location

111 Graymoor LN
Olympia Fields, IL 60461-1204

Mailing address

111 Graymoor LN
Olympia Fields, IL 60461-1204
Phone (773) 603-0782

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
149022814ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whosoever LLC Clinical CurrentSince May 16, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1710623756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GRAYMOOR LN",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611204",
            "telephone_number": "773-603-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GRAYMOOR LN",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611204",
            "telephone_number": "773-603-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYERS",
        "first_name": "MARQUISE",
        "middle_name": "DEMONE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.