Individual provider Active NPI

Mary Michelle Berkos, LCSW

  • Clinical Social Worker
  • Hoffman Estates, IL
National Provider Identifier
1861670382
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014342 Issued in IL
Practice address
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone
(847) 755-8090
Fax
(847) 843-7393
NPI assigned
Feb 6, 2008
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 149.014342 IL Primary

Addresses

Primary practice location

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029

Mailing address

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090

Other names 1

  • Mrs. Mary Michelle Amore Former name

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
I20140312001121 IL Practitioner - Clinical Social Worker 0446480545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014342ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Behavioral Health Hospital Clinical CurrentSince Jun 22, 2015 Accepting new patients

Locations

1650 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (800) 432-5005

1786 Moon Lake Blvd
Ste 104
Hoffman Estates, IL 60169

Interoperability endpoints

  • Direct secure messaging: mary.berkos.1@15182.direct.athenahealth.com

Organizations & group practices 1

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1861670382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOS",
        "first_name": "MARY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "AMORE",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "MSW, LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.