Active NPI
Maxwell Wolcott
- Social Worker
- Orland Park, IL
National Provider Identifier
1790234292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.102023
- Practice address
- 1800 Ravinia PL
Orland Park, IL 60462-3761 - Phone
- (301) 717-9173
- NPI assigned
- Sep 25, 2016
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.102023 | IL | Primary |
Addresses
Primary practice location
1800 Ravinia PL
Orland Park, IL 60462-3761
Mailing address
2439 N Mozart St
Chicago, IL 60647-2613
Phone (301) 717-9173
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150.102023 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474761600000",
"number": "1790234292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2439 N MOZART ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472613",
"telephone_number": "301-717-9173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 RAVINIA PL",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623761",
"telephone_number": "301-717-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLCOTT",
"first_name": "MAXWELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-25",
"last_updated": "2016-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.102023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.