Active NPI
James Bolo, LCSW
- Clinical Social Worker
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149015623
- Practice address
- 820 S Damen Ave
Chicago, IL 60612-3728 - Phone
- (312) 569-6788
- NPI assigned
- Feb 17, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 149015623 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
Chicago, IL 60612-3728
Mailing address
820 S Damen Ave
Chicago, IL 60612-3728
Phone (312) 569-6788
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
206 N Randolph St
2ND Floor Private Office 246
Champaign, IL 61820-3976
Phone (833) 351-8255
7433 N Clark St
Chicago, IL 60626-1619
Phone (773) 338-8778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Clinical | Current | Accepting new patients |
Locations
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
7433 N Clark St
Chicago, IL 60626
Phone (312) 756-0468
3450 Oakton St
Ste 300
Skokie, IL 60076
Organizations & group practices 2
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.
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- Psychiatry Physician
- Jacksonville, FL
- NPI 1659003457
IL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1841681582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-6788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-6788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLO",
"first_name": "JAMES",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-17",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149015623",
"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 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.