Jessica Urban, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149016169 Issued in IL

Practice address

391 North Ave
Antioch, IL 60002-3204

Phone

(224) 678-1710

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Positive Pathways

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1578271235
  NPD Authorized official

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1821444506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600840844",
            "telephone_number": "224-678-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 NORTH AVE",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023204",
            "telephone_number": "224-678-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2022-11-24",
        "certification_date": "2022-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5951",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Viezjo LLC
• Village of Antioch

• Clinical Social Worker in Antioch, IL
• Providers in Antioch, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.