Individual provider Active NPI

Nicole Carmel Du Mont, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1912563339
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016395 Issued in IL
Practice address
1701 W Greenleaf Ave Apt 2
Chicago, IL 60626-2420
Phone
(630) 544-7031
NPI assigned
May 10, 2019
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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 149.016395 IL Primary

Addresses

Primary practice location

1701 W Greenleaf Ave Apt 2
Chicago, IL 60626-2420

Mailing address

1701 W Greenleaf Ave Apt 2
Chicago, IL 60626-2420
Phone (630) 544-7031

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
I20250407000647 IL Practitioner - Clinical Social Worker 9436673936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jewish Child and Family ServicesGroup PAC ID 8628108933, 17 clinicians

Practice addresses (Care Compare)

5140 Golf Rd
Skokie, IL 60077-1206
Phone (847) 676-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016395ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Child and Family Services CurrentSince Jan 1, 2025 Accepting new patients
Jewish Child and Family Services CurrentSince Jan 1, 2025 Accepting new patients

Locations

230 W Monroe St
Ste 1100
Chicago, IL 60606
Phone (312) 357-4800

5140 Golf Rd
Skokie, IL 60077
Phone (847) 676-0078

Organizations & group practices 2

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": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1912563339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W GREENLEAF AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606262420",
            "telephone_number": "630-544-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W GREENLEAF AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606262420",
            "telephone_number": "630-544-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU MONT",
        "first_name": "NICOLE",
        "middle_name": "CARMEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.