Active NPI
Lissa J Chleboun, LSW
- Clinical Social Worker
- Warrenville, IL
National Provider Identifier
1992569065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 150.105014
- Practice address
- 4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023 - Phone
- (312) 801-5100
- NPI assigned
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 150.105014 | IL | Primary |
Addresses
Primary practice location
4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023
Mailing address
926 Maple Ave Apt 435
Downers Grove, IL 60515-7409
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 |
|---|---|---|---|
| 150.105014 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1992569065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "926 MAPLE AVE APT 435",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605157409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 WINFIELD RD STE 200",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605554023",
"telephone_number": "312-801-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHLEBOUN",
"first_name": "LISSA",
"middle_name": "J",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "150.105014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.