Individual provider Active NPI

Daniel Charles Smith, LCSW

  • Clinical Social Worker
  • Niles, IL
National Provider Identifier
1750704888
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018730 Issued in IL
Practice address
241Golf Mill Center Suite 708
Niles, IL 60714
Phone
(847) 824-8366
Fax
(847) 824-8367
NPI assigned
Jan 24, 2014
Last updated
Nov 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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 149.018730 IL Primary

Addresses

Primary practice location

241Golf Mill Center Suite 708
Niles, IL 60714

Mailing address

241 Golf Mill Ctr Ste 708
Niles, IL 60714-1208
Phone (847) 824-8366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.018730ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rosewatter Chicagoland Counseling PLLC Past Accepting new patients
Brightland Health LLC Past Accepting new patients

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, 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": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1750704888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 GOLF MILL CTR STE 708",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141208",
            "telephone_number": "847-824-8366",
            "fax_number": "847-824-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241GOLF MILL CENTER SUITE 708",
            "city": "NILES",
            "state": "IL",
            "postal_code": "60714",
            "telephone_number": "847-824-8366",
            "fax_number": "847-824-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-24",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.