Organization Active NPI

Rebecca Wise

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1912598889
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
REBECCA WISE
Practice address
2635 W Thomas St Apt 3W
Chicago, IL 60622-3412
Phone
(630) 235-7754
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Rebecca Ann Wise, LCSWNPI 1053828418
Title
President
Phone
(630) 235-7754

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2635 W Thomas St Apt 3W
Chicago, IL 60622-3412

Mailing address

2635 W Thomas St Apt 3W
Chicago, IL 60622-3412
Phone (630) 235-7754

Other names 1

  • Rebecca Wise, LCSW Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1912598889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 W THOMAS ST APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223412",
            "telephone_number": "630-235-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 W THOMAS ST APT 3W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223412",
            "telephone_number": "630-235-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA WISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-235-7754",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebecca Wise, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.