Individual provider Active NPI

Amy J Gartner, LCSW

  • Clinical Social Worker
  • Crystal Lake, IL
National Provider Identifier
1982841359
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149011534 Issued in IL
Practice address
8600 US Highway 14
Suite 105
Crystal Lake, IL 60012-2706
Phone
(815) 307-6056
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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 149011534 IL Primary

Addresses

Primary practice location

8600 US Highway 14
Suite 105
Crystal Lake, IL 60012-2706

Mailing address

3210 Prairie View Road
McHenry, IL 60050
Phone (815) 307-6056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000354 IL Practitioner - Clinical Social Worker 1153478946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Kentucky College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

360 Memorial Dr
Suite 160
Crystal Lake, IL 60014-6203
Phone (815) 307-6056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amy J. Gartner,LCSW, Inc. Clinical CurrentSince Apr 14, 2009 Accepting new patients

Locations

8600 US Highway 14
Ste 105
Crystal Lake, IL 60012
Phone (815) 307-6056

360 Memorial Dr
Ste 160
Crystal Lake, IL 60014
Phone (815) 307-6056

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.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1982841359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 PRAIRIE VIEW ROAD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-307-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 US HIGHWAY 14",
            "address_2": "SUITE 105",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122706",
            "telephone_number": "815-307-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.