Individual provider Active NPI

Nadine Beth Robertson Dimare, LCSW

  • Clinical Social Worker
  • Niles, IL
National Provider Identifier
1942605357
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.006497 Issued in IL
Practice address
999 Civic Center Dr
Niles, IL 60714-3224
Phone
(847) 588-8460
NPI assigned
Oct 28, 2014
Last updated
Oct 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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 149.006497 IL Primary

Addresses

Primary practice location

999 Civic Center Dr
Niles, IL 60714-3224

Mailing address

999 Civic Center Dr
Niles, IL 60714-3224
Phone (847) 588-8460

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

LicenseStateTypeSpecialty
149.006497ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Village of Niles Past Accepting new patients
Village of Niles Clinical PastSince Jan 1, 2008 Accepting new patients

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": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1942605357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 CIVIC CENTER DR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143224",
            "telephone_number": "847-588-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 CIVIC CENTER DR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143224",
            "telephone_number": "847-588-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON DIMARE",
        "first_name": "NADINE",
        "middle_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.006497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.