Individual provider Active NPI

Haley Elizabeth Swanson, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1740418474
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015570 Issued in IL
Practice address
710 S Paulina St Ste 438
Chicago, IL 60612-3808
Phone
(847) 308-8485
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 149015570 IL Primary

Addresses

Primary practice location

710 S Paulina St Ste 438
Chicago, IL 60612-3808

Mailing address

743 N East Ave
Oak Park, IL 60302-1540
Phone (847) 308-8485

Other practice location 1

5425 W Lake St
Chicago, IL 60644-2342
Phone (773) 378-3047

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
I20160607000251 IL Practitioner - Clinical Social Worker 0840580684 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

710 S Paulina St
Chicago, IL 60612-3808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015570ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Sep 29, 2019 Accepting new patients
Rush University Medical Center Current Accepting new patients
Rush University Medical Center CurrentSince Aug 8, 2024 Accepting new patients
Rush University Medical Group CurrentSince Aug 8, 2024 Accepting new patients
Rush University Medical Center CurrentSince Aug 8, 2024 Accepting new patients
PCC Community Wellness Center CurrentSince Jun 2, 2016 Accepting new patients
PCC Community Wellness Center CurrentSince Jun 2, 2016 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

5425 W Lake St
Chicago, IL 60644
Phone (773) 378-3347

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

710 S Paulina St
Ste 438
Chicago, IL 60612
Phone (312) 563-2702

1653 W Congress Pkwy
Ste 739
Chicago, IL 60612
Phone (312) 942-3134

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

Organizations & group practices 7

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1740418474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 N EAST AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021540",
            "telephone_number": "847-308-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S PAULINA ST STE 438",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123808",
            "telephone_number": "847-308-8485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606442342",
            "country_code": "US",
            "telephone_number": "773-378-3047",
            "fax_number": "773-378-4028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "HALEY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.