Individual provider Active NPI

John R. Konny, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1992881742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1460 Bond St
Ste. 300
Naperville, IL 60563-6503
Phone
(630) 859-0120
Fax
(630) 355-7679
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

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

1460 Bond St
Ste. 300
Naperville, IL 60563-6503

Mailing address

PO Box 1446
Aurora, IL 60507-1446
Phone (630) 859-0120

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
I20081202000860 IL Practitioner - Clinical Social Worker 4082775507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riaz Baber MD SCGroup PAC ID 0143129031, 3 clinicians

Practice addresses (Care Compare)

1460 Bond St
Suite 130
Naperville, IL 60563-6510
Phone 6308590120103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-003501ILMDClinical Social Worker

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992881742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1446",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605071446",
            "telephone_number": "630-859-0120",
            "fax_number": "630-355-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 BOND ST",
            "address_2": "STE. 300",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605636503",
            "telephone_number": "630-859-0120",
            "fax_number": "630-355-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONNY",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "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 Naperville, IL

Sources for this page

Verify at the official NPI Registry.