Emily Honora Mysel, LCSW

Individual provider Active NPI Clinical Social Worker · Glencoe, IL

NPI 1982194882 · NPPES record last updated May 16, 2018

Key facts

NPI
1982194882
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.016616 (IL)
Practice address
675 Village CT
Glencoe, IL 60022-1609
Phone
(847) 835-5111
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Service of Glencoe (4 clinicians)

Practice addresses (Care Compare)

675 Village CT
Suite 2
Glencoe, IL 60022-1609
Phone (847) 835-5111

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180709000830 IL Practitioner - Clinical Social Worker 3678829595 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
149.016616ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service of Glencoe Current
since May 30, 2018
Accepting new patients

Locations

675 Village Ct
Ste 2
Glencoe, IL 60022
Phone (847) 835-5111

361 Park Ave
Ste 202
Glencoe, IL 60022
Phone (847) 835-5111

675 Village Ct
Glencoe, IL 60022
Phone (847) 835-4112

320 Tudor Ct
#2
Glencoe, IL 60022

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.016616 IL Yes

Addresses

Primary practice location

675 Village CT
Glencoe, IL 60022-1609

Mailing address

675 Village CT
Glencoe, IL 60022-1609
Phone (847) 835-5111

Other providers in Glencoe, IL

All providers in Glencoe, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.