Individual provider Active NPI

Sheri Bulwa, MSW

  • Social Worker
  • Lake Forest, IL
National Provider Identifier
1881135549
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
104100000X Issued in IL
Practice address
240 E Illinois Rd
Lake Forest, IL 60045-1943
Phone
(847) 234-0534
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 104150200X IL
Social Worker 104100000X 104100000X IL Primary

Addresses

Primary practice location

240 E Illinois Rd
Lake Forest, IL 60045-1943

Mailing address

3724 Provenance Way
Northbrook, IL 60062-5062
Phone (847) 642-1067

Other practice location 1

240 E Illinois Rd
Lake Forest, IL 60045-1943
Phone (847) 234-0534 ext. 3

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104100000XILMDSocial Worker
104150200XILMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1881135549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 PROVENANCE WAY",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625062",
            "telephone_number": "847-642-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E ILLINOIS RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451943",
            "telephone_number": "847-234-0534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E Illinois Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451943",
            "country_code": "US",
            "telephone_number": "847-234-0534 x3",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULWA",
        "first_name": "SHERI",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "104150200X",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "104100000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.