Individual provider Active NPI

Mary Ann Riksheim, MSW

  • Clinical Social Worker
  • Olympia Fields, IL
National Provider Identifier
1831170018
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-002586 Issued in IL
Practice address
3612 Lincoln Hwy
Suite 14B
Olympia Fields, IL 60461-1627
Phone
(708) 748-8309
Fax
(708) 748-8309
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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 149-002586 IL Primary

Addresses

Primary practice location

3612 Lincoln Hwy
Suite 14B
Olympia Fields, IL 60461-1627

Mailing address

3612 Lincoln Hwy
Suite 14B
Olympia Fields, IL 60461-1627
Phone (708) 748-8309

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
I20041008001390 IL Practitioner - Clinical Social Worker 0446219943 Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Oak Park, IL 60302
Phone (708) 990-0044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-002586ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1831170018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 LINCOLN HWY",
            "address_2": "SUITE 14B",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611627",
            "telephone_number": "708-748-8309",
            "fax_number": "708-748-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 LINCOLN HWY",
            "address_2": "SUITE 14B",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611627",
            "telephone_number": "708-748-8309",
            "fax_number": "708-748-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIKSHEIM",
        "first_name": "MARY ANN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-002586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.