Individual provider Active NPI

Wendy B. Dolin, LCSW

  • Social Worker
  • Evanston, IL
National Provider Identifier
1730198276
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
886399211 Issued in IL
Practice address
2530 Crawford Ave
Suite 219
Evanston, IL 60201-4970
Phone
(847) 251-7350
Fax
(847) 853-2600
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 886399211 IL Primary

Addresses

Primary practice location

2530 Crawford Ave
Suite 219
Evanston, IL 60201-4970

Mailing address

180 E Pearson St
#5301
Chicago, IL 60611-2130
Phone (312) 649-9515

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
I20081007000592 IL Practitioner - Clinical Social Worker 2769550599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2530 Crawford Ave
Suite 219
Evanston, IL 60201-4959
Phone (847) 910-2346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
886399211ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy B. Dolin, LCSW, LLC CurrentSince May 2, 2013 Accepting new patients
Family Service Center of Wilmette Glenview Northbrook Kenilworth PastSince Nov 9, 2022 Accepting new patients

Locations

2530 Crawford Ave
Ste 219
Evanston, IL 60201
Phone (847) 840-9719

Organizations & group practices 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1730198276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PEARSON ST",
            "address_2": "#5301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112130",
            "telephone_number": "312-649-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE",
            "address_2": "SUITE 219",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014970",
            "telephone_number": "847-251-7350",
            "fax_number": "847-853-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLIN",
        "first_name": "WENDY",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "886399211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.