Individual provider Active NPI

Christian Meyer, LSW

  • Social Worker
  • Deerfield, IL
National Provider Identifier
1811723364
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.114042 Issued in IL
Practice address
1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone
(847) 498-5437
Fax
(847) 498-5438
NPI assigned
Sep 11, 2024
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.114042 IL Primary

Addresses

Primary practice location

1161 Lake Cook Rd
Deerfield, IL 60015-5649

Mailing address

1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone (847) 498-5437

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
150.114042ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KGH Consultation & Treatment, Inc. CurrentSince Sep 15, 2024 Accepting new patients

Locations

1161 Lake Cook Rd
Deerfield, IL 60015
Phone (224) 284-2240

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": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1811723364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "847-498-5437",
            "fax_number": "847-498-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "847-498-5437",
            "fax_number": "847-498-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "CHRISTIAN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.114042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.