Individual provider Active NPI

Vicky D. Oliver, LCSW

  • Social Worker
  • Tinley Park, IL
National Provider Identifier
1861414443
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
141-002181 Issued in IL
Practice address
16860 Oak Park Ave
Ste 103
Tinley Park, IL 60477-2008
Phone
(219) 836-8806
Fax
(708) 283-8770
NPI assigned
Jul 24, 2006
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 34001877A IN
Social Worker 104100000X 141-002181 IL Primary

Addresses

Primary practice location

16860 Oak Park Ave
Ste 103
Tinley Park, IL 60477-2008

Mailing address

16860 Oak Park Ave
Ste 103
Tinley Park, IL 60477-2008
Phone (798) 283-8777

Other identifiers 1

IdentifierTypeStateIssuer
219780OtherINMEDICARE

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
I20110303000723 IL Practitioner - Clinical Social Worker 2567422561 Practice locations: Tinley Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16860 Oak Park Ave
Suite 103
Tinley Park, IL 60477-2008
Phone (708) 283-8777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
141-002181ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1861414443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16860 OAK PARK AVE",
            "address_2": "STE 103",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772008",
            "telephone_number": "798-283-8777",
            "fax_number": "708-283-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16860 OAK PARK AVE",
            "address_2": "STE 103",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772008",
            "telephone_number": "219-836-8806",
            "fax_number": "708-283-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "VICKY",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34001877A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "141-002181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "219780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.