Active NPI
Paul R McNulty, MSW
- Clinical Social Worker
- Bloomingdale, IL
National Provider Identifier
1902966906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149004338
- Practice address
- 1 Tiffany PT
Ste 117
Bloomingdale, IL 60108-2936 - Phone
- (630) 673-5510
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149004338 | IL | Primary |
Addresses
Primary practice location
1 Tiffany PT
Ste 117
Bloomingdale, IL 60108-2936
Mailing address
1 N 270 Ellis Ave
Carol Stream, IL 60188
Phone (630) 653-6214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149004338 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1902966906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 N 270 ELLIS AVE",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "60188",
"telephone_number": "630-653-6214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 TIFFANY PT",
"address_2": "STE 117",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082936",
"telephone_number": "630-673-5510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNULTY",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149004338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.