Active NPI
Paul Ninnemann
- Clinical Social Worker
- Hazel Crest, IL
National Provider Identifier
1760863542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149021791
- Practice address
- 1909 Cheker SQ
Hazel Crest, IL 60429-1442 - Phone
- (708) 444-1012
- NPI assigned
- Jun 17, 2015
- Last updated
- Jan 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149021791 | IL | Primary |
Addresses
Primary practice location
1909 Cheker SQ
Hazel Crest, IL 60429-1442
Mailing address
17746 Oak Park Ave
Tinley Park, IL 60477-3936
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10602 Southwest Hwy
Chicago Ridge, IL 60415-1429
Phone (708) 448-1540
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Post Acute Care PLLC | Clinical | Current | Accepting new patients |
Locations
2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437
10602 Southwest Hwy
Chicago Ridge, IL 60415
Phone (708) 448-1540
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": "1434499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1760863542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17746 OAK PARK AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604773936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 CHEKER SQ",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604291442",
"telephone_number": "708-444-1012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NINNEMANN",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-17",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149021791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hazel Crest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.