Chester Joseph Dziuban, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014980 Issued in IL

Practice address

1801 Roberts St
Wilmington, IL 60481-1730

Phone

(815) 529-6874

NPI assigned

Feb 14, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• CJ Dziuban, LCSW, LLC

  • Mental Health Counselor
  • Wilmington, IL
  • NPI 1376215319
  NPD Authorized official
• Crossroads Counseling Services, PLLC

  • Adult Mental Health Clinic/Center
  • Yorkville, IL
  • NPI 1376247643
  NPD (past)
• Crossroads Counseling Services, PLLC

  • Adult Mental Health Clinic/Center
  • Morris, IL
  • NPI 1427205111

  Clinical

  NPD (past)

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1881967396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ROBERTS ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604811730",
            "telephone_number": "815-529-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ROBERTS ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604811730",
            "telephone_number": "815-529-6874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Bremer St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "IL",
            "postal_code": "604811304",
            "country_code": "US",
            "telephone_number": "815-529-6874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DZIUBAN",
        "first_name": "CHESTER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-14",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Anthony Carollo, D.D.S.
• Larissa Chaidez
• Sanjay Chatrath, DO
• CJ Dziuban, LCSW, LLC
• Carrie Cullick, MSN, FNP
• Elizabeth M Eaton, LCPC
• Embassy Care Center
• Embassy Holdings LLC
• Fitzsimmons Chiropractic P.C.
• Mary Melissa Fitzsimmons, D.C.

• All providers in Wilmington, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.