Active NPI
Suzanne Mascorro, LSW
- Social Worker
- Chicago, IL
National Provider Identifier
1770013716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.101771
- Practice address
- 4101 N Ravenswood Ave
Chicago, IL 60613-2193 - Phone
- (773) 572-5500
- NPI assigned
- Jun 13, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.101771 | IL | Primary |
Addresses
Primary practice location
4101 N Ravenswood Ave
Chicago, IL 60613-2193
Mailing address
4101 N Ravenswood Ave
Chicago, IL 60613-2193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 4, 2024 through Dec 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.101771 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urban Wellness, LTD. | Past | Accepting new patients |
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.
-
- Professional Counselor
- Chicago, IL
- NPI 1942565353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1770013716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 N RAVENSWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 N RAVENSWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132193",
"telephone_number": "773-572-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASCORRO",
"first_name": "SUZANNE",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-13",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.101771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.