Individual provider Active NPI

Ann Hermes Tudor, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1831521665
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149011283 Issued in IL
Practice address
4201 N Kilpatrick Ave
Chicago, IL 60641-1625
Phone
(773) 343-3379
NPI assigned
Aug 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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 149011283 IL Primary

Addresses

Primary practice location

4201 N Kilpatrick Ave
Chicago, IL 60641-1625

Mailing address

2150 W Harrison St
Chicago, IL 60612-3706
Phone (312) 942-4450

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149011283ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1831521665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "312-942-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 N KILPATRICK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411625",
            "telephone_number": "773-343-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMES TUDOR",
        "first_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-03",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.