MARK HARRIS (LCSW) – Counselor, NPI 1083217061

MARK HARRIS (LCSW) is a healthcare provider. based in Frankfort, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149026521 (IL). The NPI Number for MARK HARRIS (LCSW) is 1083217061

Main info

Male
10 Years Of Experience
Accepts Medicare Assignment
Name
MARK HARRIS (LCSW)
NPI
1083217061
Phone
(708) 271-7363
Address
21200 S LAGRANGE RD # 120
Enumeration Date
20 November 2020
Last Update Date
6 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7738545567
Graduation Year
2016 (10 years ago)
PAC ID
4981132016
Group Practice PAC ID
5193725893
Professional Enrollment ID
I20250116002131
Address ID
IL606445059CH645XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for MARK HARRIS (LCSW)

  • 21200 S LAGRANGE RD # 120

    FRANKFORT, IL 604232003

    Phone: (708) 271-7363

    Type: Mailing

  • 4235 S KING DRIVE AVE UNIT 1

    CHICAGO, IL 60653

    Phone: (708) 271-7363

    Type: Location

  • 1449 S MICHIGAN AVE # 512

    CHICAGO, IL 606052810

    Phone: (708) 271-7363

    Type: Mailing

  • 645 S CENTRAL AVE

    CHICAGO, IL 606445059

    Phone: (773) 854-5820

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250116002131IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60423)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193725893View full group profile
NameSpecialtyState
Emergency Medicine, Internal MedicineIL
-IL
Psychiatry, NeuropsychiatryIL
-IL
-IL
-IL
Diagnostic RadiologyIL
Emergency MedicineIL
Family PracticeTX
Emergency MedicineFL

Reviews

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Frequently asked questions

How do I look up MARK HARRIS (LCSW) by NPI?
Use NPI 1083217061 when you need to reference MARK HARRIS (LCSW) in forms, claims, or directories.
Is MARK HARRIS (LCSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is MARK HARRIS (LCSW)?
The page reflects Counselor for MARK HARRIS (LCSW). Clinical services aligned with this taxonomy classification.
Where is MARK HARRIS (LCSW)'s primary listing?
We display Frankfort, Illinois because that is what the record indicates for MARK HARRIS (LCSW).
What if Frankfort, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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