Individual provider Active NPI

Gina Alexandra Sourelis-Smith, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1881914125
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012923 Issued in IL
Practice address
676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954
Phone
(312) 695-5060
Fax
(312) 695-5010
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 149.012923 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954

Mailing address

676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954
Phone (312) 695-5060

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
I20190306001549 IL Practitioner - Clinical Social Worker 0143569350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

676 N Saint Clair
Chicago, IL 60611-2927

676 N Saint Clair St
Chicago, IL 60611-2927

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012923ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Aug 20, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 3, 2025 Accepting new patients
Cook County Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 3, 2025 Accepting new patients
Cook County CurrentSince Aug 20, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1900 W Polk St
Chicago, IL 60612
Phone (312) 864-0060

676 N Saint Clair St
Ste 1100
Chicago, IL 60611

2020 W Harrison St
Chicago, IL 60612
Phone (312) 572-4500

675 N Saint Clair St
Ste 14-200
Chicago, IL 60611
Phone (312) 695-7382

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1881914125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-695-5060",
            "fax_number": "312-695-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-695-5060",
            "fax_number": "312-695-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURELIS-SMITH",
        "first_name": "GINA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.