Individual provider Active NPI

Peter Tsurkis, LCSW

  • Clinical Social Worker
  • Wheeling, IL
National Provider Identifier
1831797315
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019415 Issued in IL
Practice address
905 Pebble Dr
Wheeling, IL 60090-3921
Phone
(224) 226-4212
NPI assigned
Oct 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149019415 IL Primary

Addresses

Primary practice location

905 Pebble Dr
Wheeling, IL 60090-3921

Mailing address

905 Pebble Dr
Wheeling, IL 60090-3921
Phone (224) 226-4212

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
I20221008000312 IL Practitioner - Clinical Social Worker 3870979248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Council for Jewish ElderlyGroup PAC ID 8224932702, 20 clinicians

Practice addresses (Care Compare)

1551 Lake Cook Rd
Deerfield, IL 60015-5651
Phone (847) 374-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Jewish Elderly Clinical CurrentSince Dec 16, 2022 Accepting new patients

Locations

3003 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

3033 W Touhy Ave
Chicago, IL 60645
Phone (773) 508-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1831797315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 PEBBLE DR",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903921",
            "telephone_number": "224-226-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 PEBBLE DR",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903921",
            "telephone_number": "224-226-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSURKIS",
        "first_name": "PETER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

Verify at the official NPI Registry.