Individual provider Active NPI

Alvinnetta Burks, LCSW,

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1801163365
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-003231 Issued in IL
Practice address
1335 S Prairie Ave
Unit 608
Chicago, IL 60605-3121
Phone
(708) 846-9195
NPI assigned
Nov 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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 149-003231 IL Primary

Addresses

Primary practice location

1335 S Prairie Ave
Unit 608
Chicago, IL 60605-3121

Mailing address

1335 S Prairie Ave
Unit 608
Chicago, IL 60605-3121
Phone (708) 846-9195

Other identifiers 1

IdentifierTypeStateIssuer
149-3231OtherILLICENSED CLINICAL SOCIAL WORKER

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
149-003231ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1801163365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 S PRAIRIE AVE",
            "address_2": "UNIT 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053121",
            "telephone_number": "708-846-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 S PRAIRIE AVE",
            "address_2": "UNIT 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053121",
            "telephone_number": "708-846-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "ALVINNETTA",
        "credential": "LCSW,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-003231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "149-3231",
            "state": "IL"
        }
    ],
    "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 Nov 28, 2011; 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.