Individual provider Active NPI

Nitza Solis, LCSW

  • Clinical Social Worker
  • Elk Grove Village, IL
National Provider Identifier
1811512395
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
150.104330 Issued in IL
Practice address
1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone
(773) 391-7767
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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 150.104330 IL Primary

Addresses

Primary practice location

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217

Mailing address

1257 Dover LN
Elk Grove Village, IL 60007-3828
Phone (773) 391-7767

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
I20230420001356 IL Practitioner - Clinical Social Worker 4981069218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenneth Young CenterGroup PAC ID 7416940655, 23 clinicians

Practice addresses (Care Compare)

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone (847) 524-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.104330ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Young Center CurrentSince Mar 28, 2023 Accepting new patients

Locations

1001 Rohlwing Rd
Elk Grove Vlg, IL 60007

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1811512395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 DOVER LN",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073828",
            "telephone_number": "773-391-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROHLWING RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073217",
            "telephone_number": "773-391-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIS",
        "first_name": "NITZA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150.104330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.