Individual provider Active NPI

Charlotte Denise Gilmore-Williams

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1801505821
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018706 Issued in IL
Practice address
1711 N Sayre Ave
Chicago, IL 60707-4324
Phone
(773) 718-0794
NPI assigned
Nov 17, 2022
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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 149.018706 IL Primary

Addresses

Primary practice location

1711 N Sayre Ave
Chicago, IL 60707-4324

Mailing address

1711 N Sayre Ave
Chicago, IL 60707-4324
Phone (773) 718-0794

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
149.018706ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1801505821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 N SAYRE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074324",
            "telephone_number": "773-718-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 N SAYRE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074324",
            "telephone_number": "773-718-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE-WILLIAMS",
        "first_name": "CHARLOTTE",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018706",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 17, 2022; 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.