Individual provider Active NPI

Orlando Davis, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1730425364
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015621 Issued in IL
Practice address
9204 S Commercial Ave
Suite 208
Chicago, IL 60617-2197
Phone
(312) 489-7559
Fax
(888) 419-3986
NPI assigned
Dec 31, 2012
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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 149015621 IL Primary

Addresses

Primary practice location

9204 S Commercial Ave
Suite 208
Chicago, IL 60617-2197

Mailing address

9204 S Commercial Ave
Suite 208
Chicago, IL 60617-2197
Phone (888) 417-0274

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
I20130826001018 IL Practitioner - Clinical Social Worker 2163665944 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Chicago, Pritzker School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10208 S Indianapolis Ave
Suite 237
Chicago, IL 60617-6033
Phone (312) 436-1928

3501 E 106TH St
Suite 102
Chicago, IL 60617-6625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
On the Move Solutions, Inc. Past Accepting new patients

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": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1730425364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9204 S COMMERCIAL AVE",
            "address_2": "SUITE 208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172197",
            "telephone_number": "888-417-0274",
            "fax_number": "888-419-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9204 S COMMERCIAL AVE",
            "address_2": "SUITE 208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172197",
            "telephone_number": "312-489-7559",
            "fax_number": "888-419-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ORLANDO",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-31",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.