Jillu Panavelil Mathew

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020218 Issued in IL

Practice address

119 Blackhawk CT Unit 5
Wood Dale, IL 60191-2813

Phone

(201) 527-5309

NPI assigned

Feb 22, 2017

Last updated

Jul 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jillu Panavelil Former name

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700

  IL

  Medicare reassignment Care Compare group NPD
• Cognitive Care Counseling, PLLC

  • Clinical Social Worker
  • Huntley, IL
  • NPI 1013532191
  Medicare reassignment NPD
• Illinois Geriatric Psychological Services P.C.

  • Clinical Psychologist
  • Harvard, IL
  • NPI 1184999310
  NPD (past)

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1730628793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BLACKHAWK CT UNIT 5",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912813",
            "telephone_number": "201-527-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BLACKHAWK CT UNIT 5",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912813",
            "telephone_number": "201-527-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "JILLU",
        "middle_name": "PANAVELIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLU",
            "last_name": "PANAVELIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Look Sharp Eye Care Specialists LTD
• Ada Lu
• Luxottica of America Inc. (Pearle Vision #1876)
• Jessica Mascenic, LCPC, ATR-BC
• Hannah Massey, DC
• Tamara Jane Maynard-Robbins
• Michael Paul McAuliffe, DC
• Joselyn Ann Meadows, CCC-SLP
• Osman T Meah, PHARMD
• George K. Michalopoulos, D.C.

• Clinical Social Worker in Wood Dale, IL
• Providers in Wood Dale, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.