Active NPI
Jessica Amedeo
- Clinical Social Worker
- Downers Grove, IL
National Provider Identifier
1851839237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014176
- Practice address
- 5600 Carpenter St
Downers Grove, IL 60516-1355 - Phone
- (773) 790-2147
- NPI assigned
- Feb 7, 2017
- Last updated
- Feb 7, 2017
- Sex
- Female
- 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 | 149.014176 | IL | Primary |
Addresses
Primary practice location
5600 Carpenter St
Downers Grove, IL 60516-1355
Mailing address
5600 Carpenter St
Downers Grove, IL 60516-1355
Phone (773) 790-2147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 24, 2019 through Jun 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.014176 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1851839237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5600 CARPENTER ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605161355",
"telephone_number": "773-790-2147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 CARPENTER ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605161355",
"telephone_number": "773-790-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEDEO",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-07",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.