Individual provider Active NPI

Charles Edward Preyar, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1851548176
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149001874 Issued in IL
Practice address
11214 S Longwood Dr
Chicago, IL 60643-4126
Phone
(773) 233-2017
NPI assigned
Aug 19, 2008
Last updated
Aug 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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 149001874 IL Primary

Addresses

Primary practice location

11214 S Longwood Dr
Chicago, IL 60643-4126

Mailing address

11214 S Longwood Dr
Chicago, IL 60643-4126

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
I20150624002367 IL Practitioner - Clinical Social Worker 7810208378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149001874ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Energize Group, Inc Clinical CurrentSince Mar 1, 2022 Accepting new patients
Upscale Social Services, P C Clinical Past Accepting new patients
Energize Group, Inc Clinical Past Accepting new patients

Locations

5130 W Jackson Blvd
Chicago, IL 60644
Phone (773) 287-1429

4950 Madison St
Unit 1391
Skokie, IL 60076

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1851548176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11214 S LONGWOOD DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11214 S LONGWOOD DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434126",
            "telephone_number": "773-233-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREYAR",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149001874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.