Individual provider Active NPI

James Boggess

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1902216849
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.007483 Issued in IL
Practice address
2656 W Montrose Ave
Chicago, IL 60618-1559
Phone
(773) 267-5795
Fax
(773) 267-4787
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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 149.007483 IL Primary

Addresses

Primary practice location

2656 W Montrose Ave
Chicago, IL 60618-1559

Mailing address

2656 W Montrose Ave
Chicago, IL 60618-1559
Phone (773) 267-5795

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
I20150512001472 IL Practitioner - Clinical Social Worker 3274852322 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.007483ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Feb 4, 2020 Accepting new patients
Crossroads Counseling Services, PLLC Clinical CurrentSince Aug 2, 2015 Accepting new patients
Mary and Tom Leo Associates, Inc. Past Accepting new patients

Locations

1802 N Division St
Ste 509
Morris, IL 60450
Phone (815) 941-4700

601 W Norris Dr
Ste B
Ottawa, IL 61350
Phone (815) 431-1800

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

Organizations & group practices 3

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1902216849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2656 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181559",
            "telephone_number": "773-267-5795",
            "fax_number": "773-267-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2656 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181559",
            "telephone_number": "773-267-5795",
            "fax_number": "773-267-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGESS",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.007483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.