Individual provider Active NPI

Connie Leann Trujillo, MSW, LCSW

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1952691180
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013773 Issued in IL
Practice address
5151 Church St
Skokie, IL 60077-1123
Phone
(847) 933-9200
NPI assigned
Apr 8, 2011
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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 149.013773 IL Primary

Addresses

Primary practice location

5151 Church St
Skokie, IL 60077-1123

Mailing address

5151 Church St
Skokie, IL 60077-1123
Phone (847) 933-9200

Other practice location 1

305 S Illinois St
Belleville, IL 62220-2133
Phone (618) 235-1703

Other names 1

  • Ms. Connie Leann McCarthy Professional name

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
149.013773ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Care Consultants NFP Past Accepting new patients
Hospice of Southern Illinois, Inc. Past 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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1952691180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771123",
            "telephone_number": "847-933-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771123",
            "telephone_number": "847-933-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 S Illinois St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622202133",
            "country_code": "US",
            "telephone_number": "618-235-1703",
            "fax_number": "618-222-6831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "CONNIE",
        "middle_name": "LEANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "MCCARTHY",
            "middle_name": "LEANN",
            "prefix": "MS.",
            "credential": "MSW, LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.