Active NPI
Cruz Manuel Meza, LCSW
- Clinical Social Worker
- Burr Ridge, IL
National Provider Identifier
1972269223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149023682
- Practice address
- 277 83Rd St
Suite D
Burr Ridge, IL 60527 - Phone
- (630) 891-3027
- NPI assigned
- Nov 11, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149023682 | IL | Primary |
Addresses
Primary practice location
277 83Rd St
Suite D
Burr Ridge, IL 60527
Mailing address
440 Eagle Dr Apt 206
Elk Grove Village, IL 60007-4737
Phone (773) 307-5804
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149023682 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1972269223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 EAGLE DR APT 206",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600074737",
"telephone_number": "773-307-5804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 83RD ST",
"address_2": "SUITE D",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "60527",
"telephone_number": "630-891-3027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEZA",
"first_name": "CRUZ",
"middle_name": "MANUEL",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-11",
"last_updated": "2021-11-11",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149023682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
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- William F Mieler, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.