Amanda Matousek, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019050 Issued in IL

Practice address

3436 N Kennicott Ave
Arlington HTS, IL 60004-7814

Phone

(847) 952-7460

Fax

(847) 222-1754

NPI assigned

Nov 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1861934606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-964-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOUSEK",
        "first_name": "AMANDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150015319",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "201543752",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marvin Harvey Margolis, M.D.
• Neil Woolf Margolis, OD
• Vanessa Martinez de Baklazec, RPN
• Gerard R Marty, MD
• Marvin H Margolis MD SC
• Martin M Matus, O.D.
• Michael Charles Menyhart, DDS
• Michele Armenia, M.D., S.C.
• Marta Micko, MA, LCPC
• Midwest Physical Therapy Ctr

• Clinical Social Worker in Arlington HTS, IL
• Providers in Arlington HTS, 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 Oct 11, 2017; 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.