Active NPI
Jessica L Quirini
- Clinical Social Worker
- Antioch, IL
National Provider Identifier
1831678739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149020394
- Practice address
- 800 Main St
Antioch, IL 60002-1542 - Phone
- (847) 903-5604
- Fax
- (224) 788-5112
- NPI assigned
- Aug 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149020394 | IL | Primary |
Addresses
Primary practice location
800 Main St
Antioch, IL 60002-1542
Mailing address
PO Box 856
Antioch, IL 60002-0856
Phone (847) 903-5604
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149020394 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1831678739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 856",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600020856",
"telephone_number": "847-903-5604",
"fax_number": "224-788-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 MAIN ST",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600021542",
"telephone_number": "847-903-5604",
"fax_number": "224-788-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIRINI",
"first_name": "JESSICA",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-10",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149020394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.