Individual provider Active NPI

Tiffany Lynn Bongiorno, LCSW

  • Clinical Social Worker
  • Addison, IL
National Provider Identifier
1912182148
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018601 Issued in IL
Practice address
303 W Lake St Ste 304
Addison, IL 60101-2586
Phone
(331) 221-1650
NPI assigned
Jan 7, 2008
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 112445021 TN
Clinical Social Worker 1041C0700X 149018601 IL Primary

Addresses

Primary practice location

303 W Lake St Ste 304
Addison, IL 60101-2586

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700

Other practice location 1

303 W Lake St Ste 301
Addison, IL 60101-2565
Phone (331) 221-1650

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
I20180830002352 IL Practitioner - Clinical Social Worker 9638429392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112445021TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 6, 2024 Accepting new patients
Edward Health Ventures CurrentSince Jul 15, 2018 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Edward Health Ventures CurrentSince Jul 15, 2018 Accepting new patients

Locations

303 W Lake St
Ste 301
Addison, IL 60101
Phone (331) 221-1650

303 W Lake St
Ste 304
Addison, IL 60101
Phone (331) 221-1650

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1912182148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W LAKE ST STE 304",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012586",
            "telephone_number": "331-221-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W Lake St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601012565",
            "country_code": "US",
            "telephone_number": "331-221-1650",
            "fax_number": "331-221-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "112445021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.