Individual provider Active NPI

Robert Benson Sanoshy, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1851588461
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-012624 Issued in IL
Practice address
7731 N Paulina St Apt 3
Chicago, IL 60626-1062
Phone
(773) 991-5321
NPI assigned
Sep 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 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 Worker 1041C0700X 149-012624 IL Primary

Addresses

Primary practice location

7731 N Paulina St Apt 3
Chicago, IL 60626-1062

Mailing address

7731 N Paulina St Apt 3
Chicago, IL 60626-1062
Phone (773) 991-5321

Other practice location 1

4753N Broadway St 818
Chicago, IL 60640-4992
Phone (773) 991-5321

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
I20080401000635 IL Practitioner - Clinical Social Worker 5395822308 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4753 N Broadway St
Suite 818
Chicago, IL 60640-4992
Phone (773) 991-5321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-012624ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1851588461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7731 N PAULINA ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261062",
            "telephone_number": "773-991-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7731 N PAULINA ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261062",
            "telephone_number": "773-991-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4753N BROADWAY ST 818",
            "address_purpose": "LOCATION",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404992",
            "country_code": "US",
            "telephone_number": "773-991-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANOSHY",
        "first_name": "ROBERT",
        "middle_name": "BENSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-012624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.