Individual provider Active NPI

Susan Bachman, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1720543689
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149008957 Issued in IL
Practice address
2132 W Roscoe St
Chicago, IL 60618-6241
Phone
(773) 880-0947
NPI assigned
Feb 5, 2019
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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 149008957 IL Primary

Addresses

Primary practice location

2132 W Roscoe St
Chicago, IL 60618-6241

Mailing address

2132 W Roscoe St
Chicago, IL 60618-6241
Phone (773) 880-0947

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190429001444 IL Practitioner - Clinical Social Worker 9032451794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2132 W Roscoe St
Unit 2
Chicago, IL 60618-6241
Phone (773) 880-0947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149008957ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Bachman, LCSW,SC CurrentSince May 1, 2019 Accepting new patients

Locations

2132 W Roscoe St
Chicago, IL 60618
Phone (310) 384-3322

2132 W Roscoe St
#2
Chicago, IL 60618
Phone (773) 828-9122

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": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1720543689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186241",
            "telephone_number": "773-880-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186241",
            "telephone_number": "773-880-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHMAN",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.