Individual provider Active NPI

Xochitl Sandoval, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1891191144
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021828 Issued in IL
Practice address
2451 N Lincoln Ave
Chicago, IL 60614-1509
Phone
(708) 769-0782
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 149.021828 IL Primary

Addresses

Primary practice location

2451 N Lincoln Ave
Chicago, IL 60614-1509

Mailing address

4824 S Kedvale Ave
Chicago, IL 60632-4107

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
I20250219001057 IL Practitioner - Clinical Social Worker 3678093838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

4815 S Western Blvd
Chicago, IL 60609-4067
Phone (630) 857-8311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021828ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Castillo for Personal and Family Wellbeing, LLC CurrentSince Mar 1, 2025 Accepting new patients
Leyden Family Service & Mental Health Center Past Accepting new patients
Leyden Family Service & Mental Health Center Past Accepting new patients

Locations

3166 N Lincoln Ave
Ste 224
Chicago, IL 60657
Phone (773) 622-6218

6250 W North Ave
#1
Chicago, IL 60639
Phone (773) 309-8012

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.xochitlsandoval@146897.advancedmd-direct.com

Organizations & group practices 4

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1891191144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 S KEDVALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141509",
            "telephone_number": "708-769-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "XOCHITL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.