MR. JACK CHARLES SANDERS (NPI# 1588738652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588738652 |
| Entity Type | Individual |
| Full Name | MR. JACK CHARLES SANDERS |
| Credential | MSW |
| Practice Address |
6650 North Northwest Hwy Suite 201 Chicago IL 60631-1307 |
| Mailing Address |
2229 West Farwell Ave 1 West Chicago IL 60645-4809 |
| Practice Telephone | 7734671154 |
| Practice Fax Number | 7732627237 |
| Mailing Telephone | 7734671154 |
| Mailing Fax Number | 7732627237 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD IL | 01633967 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619050150 | Jack Larry Sanders | Pharmacist | 3160 Audubon Dr, Laurel, MS 39440 | 2006-10-20 |
| Street Address |
6650 NORTH NORTHWEST HWY SUITE 201 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60631-1307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686609 | Martha Agnes Bissing | Student in an Organized Health Care Education/Training Program | Resurrection Medical Education, Karen Dwulat, 7435 W. Talcott Avenue, Chicago, IL 60631 | 2020-04-01 |
| 1497383434 | Kathryn Lee Hughes | Student in an Organized Health Care Education/Training Program | 7435 W Talcott Avenue, Medical Education, Karen Dwulat, Chicago, IL 60631 | 2020-03-27 |
| 1245723121 | Thomas Walsh | Student in an Organized Health Care Education/Training Program | Resurrection Family Medicine 7447 W Talcott Ave, Ste 182, Chicago, IL 60631 | 2018-06-14 |
| 1912411893 | Briggs Therapy Group, LLC | Social Worker | 6645 N Oliphant Ave Ste F, Chicago, IL 60631 | 2017-11-29 |
| 1013467257 | Elsa Methipara | Nurse Practitioner | 6429 N Ogallah, Chicago, IL 60631 | 2016-10-12 |
| 1477001766 | Djje Holdings LLC | Psychologist | 8609 W Bryn Mawr Ave Ste 204, Chicago, IL 60631 | 2016-09-14 |
| 1538512884 | Sprout Pediatric Dentistry | Dentist | 6036 North Northwest Highway, Chicago, IL 60631 | 2016-07-21 |
| 1417305137 | Christopher Louis Scodeller | Emergency Medicine | 7435 W. Talcott A, Presence Resurrection Medical Center, Chicago, IL 60631 | 2016-06-03 |
| 1518315464 | Corbin Barwegen | Emergency Medicine | 7435 W. Talcott Ave., Chicago, IL 60631 | 2016-06-01 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| Find all providers in zip 60631 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.