Jack D Neiditch, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-009897 Issued in IL

Practice address

3656 N Halsted St
Chicago, IL 60613-5974

Phone

(773) 525-9945

NPI assigned

May 20, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1861711541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W BITTERSWEET PL",
            "address_2": "UNIT 606",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132354",
            "telephone_number": "773-525-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135974",
            "telephone_number": "773-525-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDITCH",
        "first_name": "JACK",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-009897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Wayne Nehring Jr., CST/CFA/RSA
• Narois Nehru, MD
• Benjamin Jonas Triston Neichin
• Sarah Neidermann, OD
• Cameron Ryan Neidhard
• Marc Thomas Neidlinger, DPT
• Neighborhood Family Healthcare SC
• Neighborhood Health Group, LLC
• Neighborhood Healthcare Services PC
• Neighborhood Psychotherapy PLLC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.