Individual provider Active NPI

Brittany Carol Jesernik, LCSW

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1881258309
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019387 Issued in IL
Practice address
15317 Sunset Ridge Dr
Orland Park, IL 60462-4025
Phone
(708) 912-6501
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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 149019387 IL Primary

Addresses

Primary practice location

15317 Sunset Ridge Dr
Orland Park, IL 60462-4025

Mailing address

15317 Sunset Ridge Dr
Orland Park, IL 60462-4025
Phone (708) 912-6501

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
149019387ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1881258309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15317 SUNSET RIDGE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624025",
            "telephone_number": "708-912-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15317 SUNSET RIDGE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624025",
            "telephone_number": "708-912-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESERNIK",
        "first_name": "BRITTANY",
        "middle_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.