Individual provider Active NPI

Harry James Nozicka, LCSW,MSW

  • Clinical Social Worker
  • Palatine, IL
National Provider Identifier
1982755310
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1262 W Borders Dr
Palatine, IL 60067-6614
Phone
(847) 202-8671
Fax
(847) 202-7933
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1262 W Borders Dr
Palatine, IL 60067-6614

Mailing address

1262 W Borders Dr
Palatine, IL 60067-6614
Phone (847) 202-8671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 17, 2015 through Dec 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.000475ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982755310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 W BORDERS DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600676614",
            "telephone_number": "847-202-8671",
            "fax_number": "847-202-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1262 W BORDERS DR",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600676614",
            "telephone_number": "847-202-8671",
            "fax_number": "847-202-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOZICKA",
        "first_name": "HARRY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW,MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

Verify at the official NPI Registry.