Individual provider Active NPI

Debra Ann Chandler, LCSW, LPHA

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1851669097
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.011285 Issued in IL
Practice address
5757 N Sheridan Rd
Apt. 8a
Chicago, IL 60660-4746
Phone
(773) 293-1251
NPI assigned
Dec 2, 2011
Last updated
Jan 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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 149.011285 IL Primary

Addresses

Primary practice location

5757 N Sheridan Rd
Apt. 8a
Chicago, IL 60660-4746

Mailing address

5757 N. Sheridan Rd.
Apt. 8a
Chicago, IL 60660-8704
Phone (773) 293-1251

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
I20120418000802 IL Practitioner - Clinical Social Worker 4688835671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerge Physical Therapy and Wellness PLLCGroup PAC ID 4587093646, 5 clinicians

Practice addresses (Care Compare)

1962 N Bissell St
Suite 1
Chicago, IL 60614-0558
Phone (312) 598-9991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.011285ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution PTWL LLC CurrentSince Sep 17, 2019 Accepting new patients
Emerge Physical Therapy & Wellness PLLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

1962 N Bissell St
Chicago, IL 60614

1962 N Bissell St
Ste 1
Chicago, IL 60614
Phone (312) 598-9991

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

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, 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": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1851669097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 N. SHERIDAN RD.",
            "address_2": "APT. 8A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606608704",
            "telephone_number": "773-293-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 N SHERIDAN RD",
            "address_2": "APT. 8A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604746",
            "telephone_number": "773-293-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "LCSW, LPHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.