Individual provider Active NPI

Bozena Miltko

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1922566702
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019867 Issued in IL
Practice address
6508 W Archer Ave
Chicago, IL 60638-2423
Phone
(708) 642-5777
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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 149019867 IL Primary

Addresses

Primary practice location

6508 W Archer Ave
Chicago, IL 60638-2423

Mailing address

6508 W Archer Ave
Chicago, IL 60638-2423
Phone (708) 642-5777

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149019867ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1922566702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382423",
            "telephone_number": "708-642-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382423",
            "telephone_number": "708-642-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILTKO",
        "first_name": "BOZENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 11, 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.

Verify at the official NPI Registry.