Individual provider Active NPI

Elizabeth Hailey-Smith, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1801366802
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026402 Issued in IL
Practice address
8540 S Oglesby Ave
Chicago, IL 60617-2308
Phone
(312) 206-9363
Fax
(773) 437-5427
NPI assigned
Dec 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 149.026402 IL Primary

Addresses

Primary practice location

8540 S Oglesby Ave
Chicago, IL 60617-2308

Mailing address

8540 S Oglesby Ave
Chicago, IL 60617-2308
Phone (312) 206-9363

Other names 1

  • N/a N/a Professional name

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
I20240719000751 IL Practitioner - Clinical Social Worker 8325584055 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.026402ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Altea Medical Illinois PLLC CurrentSince Apr 20, 2024 Accepting new patients
Midwest Post Acute Care PLLC Clinical CurrentSince Aug 1, 2024 Accepting new patients
Post Acute Medical PLLC CurrentSince Apr 20, 2024 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

6125 S Kenwood Ave
Chicago, IL 60637
Phone (773) 752-6000

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 208-1876

900 W River Pl
Kankakee, IL 60901
Phone (815) 933-1711

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

Organizations & group practices 3

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": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1801366802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S OGLESBY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172308",
            "telephone_number": "312-206-9363",
            "fax_number": "773-437-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S OGLESBY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172308",
            "telephone_number": "312-206-9363",
            "fax_number": "773-437-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILEY-SMITH",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.