Individual provider Active NPI

Daniel R Cotton, MSW

  • Clinical Social Worker
  • Glen Ellyn, IL
National Provider Identifier
1871603720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
799 Roosevelt Rd # 3-104a
Glen Ellyn, IL 60137-5908
Phone
(630) 240-0147
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

799 Roosevelt Rd # 3-104a
Glen Ellyn, IL 60137-5908

Mailing address

6099 Mill Bridge LN
Lisle, IL 60532-2864
Phone (630) 240-0147

Other identifiers 3

IdentifierTypeStateIssuer
223226OtherILBLUE CROSS BLUE SHIELD
293793OtherILMHN
691275OtherILFIRST HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-005323ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871603720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6099 MILL BRIDGE LN",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322864",
            "telephone_number": "630-240-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 ROOSEVELT RD # 3-104A",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375908",
            "telephone_number": "630-240-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTON",
        "first_name": "DANIEL",
        "middle_name": "R",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "223226",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "293793",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "691275",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.