Jennifer Avila, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149017483 Issued in IL

Practice address

1127 N Oakley Blvd
3Rd Floor
Chicago, IL 60622-3507

Phone

(312) 770-2317

Fax

(312) 770-2557

NPI assigned

Apr 2, 2015

Last updated

Oct 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1821483124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 W OHIO ST",
            "address_2": "UNIT 16W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121298",
            "telephone_number": "312-402-0709",
            "fax_number": "312-770-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-770-2317",
            "fax_number": "312-770-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Avila-Cantore, APN, FNP-C
• Karla Johan Avila-Polanco
• Christopher Avila, DCAM
• Hector David Avila, DMD
• Jeanette Avila
• John Avila
• Jose Avila, MA
• Lucila Avila
• Patricia Avila
• Reyna M Avila

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Oct 12, 2016; 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.