Individual provider Active NPI

James Paul Simmerer, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1790982908
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
11309 Distinctive Dr
Orland Park, IL 60467-9460
Phone
(708) 228-0475
Fax
(708) 326-4095
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

11309 Distinctive Dr
Orland Park, IL 60467-9460

Mailing address

22W267 First St.
Glen Ellyn, IL 60137-3530
Phone (630) 890-1907

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
I20040715000587 IL Practitioner - Clinical Social Worker 3678550878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11309 Distinctive Dr
Orland Park, IL 60467-9490
Phone (630) 890-1907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-003104ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
James Simmerer, LCSW, Counseling & Psychotherapy Services, LLC Clinical CurrentSince Feb 26, 2004 Accepting new patients

Locations

3235 Vollmer Rd
Ste 107
Flossmoor, IL 60422
Phone (312) 203-8549

11309 Distinctive Dr
Orland Park, IL 60467
Phone (630) 789-2928

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790982908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22W267 FIRST ST.",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373530",
            "telephone_number": "630-890-1907",
            "fax_number": "708-326-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11309 DISTINCTIVE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679460",
            "telephone_number": "708-228-0475",
            "fax_number": "708-326-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMERER",
        "first_name": "JAMES",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.