Individual provider Active NPI

Adrienne Otkins, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1811197833
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012520 Issued in IL
Practice address
6601 North Ave
Oak Park, IL 60302-1084
Phone
(773) 510-6551
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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 149.012520 IL Primary

Addresses

Primary practice location

6601 North Ave
Oak Park, IL 60302-1084

Mailing address

328 N Waller Ave
Chicago, IL 60644-2248
Phone (773) 261-6551

Other identifiers 1

IdentifierTypeStateIssuer
1811197833MedicaidIL

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
I20200702001553 IL Practitioner - Clinical Social Worker 8820411291 Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6601 N Ave
Suite 5
Oak Park, IL 60302-1084
Phone (773) 510-6551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012520ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Otkins & Associates, LLC Clinical CurrentSince May 24, 2020 Accepting new patients

Locations

1010 Lake St
Ste 426
Oak Park, IL 60301
Phone (708) 214-8768

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1811197833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 N WALLER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606442248",
            "telephone_number": "773-261-6551",
            "fax_number": "773-261-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 NORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021084",
            "telephone_number": "773-510-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTKINS",
        "first_name": "ADRIENNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811197833",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.