Individual provider Active NPI

Jill C Schaub, LCSW

  • Clinical Social Worker
  • Tinley Park, IL
National Provider Identifier
1881083673
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017234 Issued in IL
Practice address
17366 Ottawa Ave
Tinley Park, IL 60477-3235
Phone
(708) 305-6728
NPI assigned
Jan 15, 2015
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 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 149.017234 IL Primary

Addresses

Primary practice location

17366 Ottawa Ave
Tinley Park, IL 60477-3235

Mailing address

17366 Ottawa Ave
Tinley Park, IL 60477-3235
Phone (708) 305-6728

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
I20191119002977 IL Practitioner - Clinical Social Worker 8628400264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Institute of Neurobehavior Services SCGroup PAC ID 7618107608, 9 clinicians

Practice addresses (Care Compare)

14315 S 108TH Ave
Suite 215
Orland Park, IL 60462-5701
Phone (708) 586-9751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.017234ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Neurobehavior Services SC CurrentSince Sep 11, 2019 Accepting new patients

Locations

14315 108th Ave
Ste 215
Orland Park, IL 60467
Phone (708) 586-9751

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1881083673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17366 OTTAWA AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773235",
            "telephone_number": "708-305-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17366 OTTAWA AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773235",
            "telephone_number": "708-305-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUB",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.