Theodore R Harris, LCSW, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016113 Issued in IL

Practice address

820 Davis St Ste 453
Evanston, IL 60201-4447

Phone

(312) 576-5760

NPI assigned

Dec 17, 2012

Sex

Male

Sole proprietor

No

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.

• Dr. Britt Borden

  • Internal Medicine Physician
  • Evanston, IL
  • NPI 1114572963
  NPD (past)

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1902142003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 ASBURY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021637",
            "telephone_number": "773-680-1534",
            "fax_number": "312-674-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 DAVIS ST STE 453",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014447",
            "telephone_number": "312-576-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Michigan Ave Ste 1120",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606014001",
            "country_code": "US",
            "telephone_number": "312-576-5760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 W Jackson Blvd",
            "address_2": "Suite 404",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606043606",
            "country_code": "US",
            "telephone_number": "312-576-5760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "THEODORE",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-17",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Harold, MD
• Donna Harrar, LMT
• Casey Harris, APN-CRNA
• Chad Eric Harris, M.ED., ATC
• Peonita Harris, M.A., LMFT
• Zakiya Harris
• Ilana Harrow, LSW, PEL
• Harry J Jaffe, MD,SC
• Avery Scott Hart, MD
• Elizabeth Hart, M.P.T.

• Clinical Social Worker in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.