Individual provider Active NPI

Juliane Klinke, LCSW

  • Clinical Social Worker
  • Oak Brook, IL
National Provider Identifier
1861936478
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012642 Issued in IL
Practice address
2625 Butterfield Rd
101N
Oak Brook, IL 60523-1234
Phone
(630) 586-0900
Fax
(630) 586-9990
NPI assigned
Dec 15, 2016
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 149.012642 IL Primary

Addresses

Primary practice location

2625 Butterfield Rd
101N
Oak Brook, IL 60523-1234

Mailing address

2625 Butterfield Rd
101N
Oak Brook, IL 60523-1234
Phone (630) 586-0900

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
I20210624001775 IL Practitioner - Clinical Social Worker 4284915224

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

704 S Weber Rd
Unit 1415
Romeoville, IL 60446-3059

PO Box
Suite 363
New Lenox, IL 60451

PO Box
Suite 7236
Romeoville, IL 60446-7136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012642ILMDClinical Social Worker
149012642ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Attention to Wellness, PLLC Past Accepting new patients

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": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1861936478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-586-0900",
            "fax_number": "630-586-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "101N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-586-0900",
            "fax_number": "630-586-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKE",
        "first_name": "JULIANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.