Individual provider Active NPI

Rebecca Ann Deurance, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1760874192
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014080 Issued in IL
Practice address
1010 Lake St Ste 200
Oak Park, IL 60301-1132
Phone
(312) 970-1494
NPI assigned
Feb 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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 149.014080 IL Primary

Addresses

Primary practice location

1010 Lake St Ste 200
Oak Park, IL 60301-1132

Mailing address

1010 Lake St Ste 200
Oak Park, IL 60301-1132
Phone (312) 970-1494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 20, 2025 through Jan 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.014080ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Deurance Therapy PLLC Clinical Current Accepting new patients

Locations

1010 Lake St
Ste 200
Oak Park, IL 60301
Phone (708) 406-9222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1760874192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011132",
            "telephone_number": "312-970-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011132",
            "telephone_number": "312-970-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEURANCE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.