Individual provider Active NPI

Ernie Miguel Calderon, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1730058348
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149028906 Issued in IL
Practice address
3665 N Broadway St
Chicago, IL 60613-4567
Phone
(773) 496-4433
Fax
(773) 496-4430
NPI assigned
Nov 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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 149028906 IL Primary

Addresses

Primary practice location

3665 N Broadway St
Chicago, IL 60613-4567

Mailing address

3665 N Broadway St
Chicago, IL 60613-4567
Phone (773) 496-4433

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
I20251216000746 IL Practitioner - Clinical Social Worker 6204320328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

314 Furlong Trce
Versailles, KY 40383-2067

PO Box
Carol Stream, IL 60197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149028906ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC Clinical CurrentSince Jan 5, 2026 Accepting new patients

Locations

3665 N Broadway St
Chicago, IL 60613
Phone (773) 496-4433

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1730058348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567",
            "telephone_number": "773-496-4433",
            "fax_number": "773-496-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567",
            "telephone_number": "773-496-4433",
            "fax_number": "773-496-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "ERNIE",
        "middle_name": "MIGUEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149028906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.