Individual provider Active NPI

Danielle Jordyn Kroll

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1770088601
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.024235 Issued in IL
Practice address
6323 N Avondale Ave Ste 140
Chicago, IL 60631-1958
Phone
(708) 665-5491
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149.024235 IL Primary

Addresses

Primary practice location

6323 N Avondale Ave Ste 140
Chicago, IL 60631-1958

Mailing address

6323 N Avondale Ave Ste 140
Chicago, IL 60631-1958
Phone (708) 665-5491

Other practice location 1

142 Hawley St Ste 5
Grayslake, IL 60030-3653
Phone (847) 549-2235

Other practice location 2

6323 N Avondale Ave Ste 140
Chicago, IL 60631-1958
Phone (708) 665-5491

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.024235ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hidden Gem Therapeutics Clinical CurrentSince Mar 12, 2023 Accepting new patients

Locations

6323 N Avondale Ave
Ste 140
Chicago, IL 60631
Phone (708) 665-5491

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1770088601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 N AVONDALE AVE STE 140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311958",
            "telephone_number": "708-665-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 N AVONDALE AVE STE 140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311958",
            "telephone_number": "708-665-5491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 Hawley St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Grayslake",
            "state": "IL",
            "postal_code": "600303653",
            "country_code": "US",
            "telephone_number": "847-549-2235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6323 N Avondale Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606311958",
            "country_code": "US",
            "telephone_number": "708-665-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROLL",
        "first_name": "DANIELLE",
        "middle_name": "JORDYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024235",
            "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 Mar 21, 2023; 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.