Douglas Van Til, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.001256 Issued in IL

Practice address

24755 S Country LN
Crete, IL 60417-2658

Phone

(800) 361-6880

Fax

(708) 845-5500

NPI assigned

Jan 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicago Christian Counseling Center IncGroup PAC ID 1052395258, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chicago Christian Counseling Center Inc

  • Clinical Social Worker
  • Orland Park, IL
  • NPI 1083664510
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1720359441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "SUITE G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "708-845-5500",
            "fax_number": "708-845-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24755 S COUNTRY LN",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604172658",
            "telephone_number": "800-361-6880",
            "fax_number": "708-845-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TIL",
        "first_name": "DOUGLAS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.001256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Teresiak
• Paula Thigpen, LCSW
• Carl Triebold, L.C.P.C, C.R.C
• Trilogy Healthcare of Will, LLC
• Uniquely Resilient PLLC
• Veld Vision Center
• Paul A Veld, O.D.
• Village of Crete
• Vip Labs LLC.
• Vivid Cranial Prosthetics

• Clinical Social Worker in Crete, IL
• Providers in Crete, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.