John H Amendt Jr., M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.001914 Issued in IL

Practice address

346 Taft Ave
Suite 030
Glen Ellyn, IL 60137-6296

Phone

(630) 690-3170

NPI assigned

May 21, 2007

Last updated

Feb 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 27, 2023 through Apr 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Marriage Clinic

  • Clinical Social Worker
  • Glen Ellyn, IL
  • NPI 1609926005
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1801005665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 BRENTWOOD LN E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898543",
            "telephone_number": "630-690-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 TAFT AVE",
            "address_2": "SUITE 030",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376296",
            "telephone_number": "630-690-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENDT",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.001914",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Always Great Smiles Dot Com PC
• Amani Optometry LLC
• Amara Physical Therapy
• Carla Amato-Martz
• Cynthia R Ambler, MD
• American Drug Stores LLC (Osco Drug #3340)
• Hafsa Amjed, M.D
• Penelope A Andersen, LCSW,LMFT,MSW
• Edwin Anderson, MD
• Jasmine Anish, FNP

• Clinical Social Worker in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.