Individual provider Active NPI

Davona V Crowley

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1770663130
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012458 Issued in IL
Practice address
9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389
Phone
(847) 676-4447
Fax
(847) 676-4450
NPI assigned
Oct 17, 2006
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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 149012458 IL Primary

Addresses

Primary practice location

9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389

Mailing address

9239 Gross Point Rd
Suite 300
Skokie, IL 60077-1389
Phone (847) 676-4447

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150218000756 IL Practitioner - Clinical Social Worker 5193810893 Practice locations: Skokie, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5225 Old Orchard Rd
24B
Skokie, IL 60077-1027
Phone (847) 595-0822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149012458ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Contextual Change Clinical PastSince Jan 1, 2007 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, 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1770663130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9239 GROSS POINT RD",
            "address_2": "SUITE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771389",
            "telephone_number": "847-676-4447",
            "fax_number": "847-676-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9239 GROSS POINT RD",
            "address_2": "SUITE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771389",
            "telephone_number": "847-676-4447",
            "fax_number": "847-676-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "DAVONA",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.