Individual provider Active NPI

Gretchen Genz Davidson, MSW, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1730165317
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-005284 Issued in IL
Practice address
1818 Dempster St
Evanston, IL 60202-1003
Phone
(847) 602-0486
Fax
(847) 602-0486
NPI assigned
Dec 16, 2005
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 149-005284 IL Primary

Addresses

Primary practice location

1818 Dempster St
Evanston, IL 60202-1003

Mailing address

1818 Dempster St
Evanston, IL 60202-1003
Phone (847) 602-0486

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
I20080626000449 IL Practitioner - Clinical Social Worker 8123190758 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

717 Main St
Evanston, IL 60202-1701
Phone (847) 602-0486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-005284ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1730165317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021003",
            "telephone_number": "847-602-0486",
            "fax_number": "847-602-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021003",
            "telephone_number": "847-602-0486",
            "fax_number": "847-602-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "GRETCHEN",
        "middle_name": "GENZ",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-005284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.