MICHAEL R BOURBON (LCSW) – Clinical Social Worker, NPI 1316012537

MICHAEL R BOURBON (LCSW) is a healthcare provider. based in Vernon hills, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149007084 (IL). The NPI Number for MICHAEL R BOURBON (LCSW) is 1316012537

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL R BOURBON (LCSW)
NPI
1316012537
Phone
(847) 918-0129
Address
977 LAKEVIEW PKWY
Enumeration Date
22 November 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8476026470
Graduation Year
1991 (35 years ago)
PAC ID
2163313172
Professional Enrollment ID
I20040322000133
Address ID
IL600611730VE10XXXRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for MICHAEL R BOURBON (LCSW)

  • 977, Lakeview Parkway, Vernon Hills, Lake County, Illinois, 60061, United States

    # 155

    VERNON HILLS, IL 600611400

    Phone: (847) 918-0129

    Fax: (847) 918-0747

    Mailing address matches the actual address.

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: 2004-03-22

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
I20040322000133IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes10817$0
View full utilization report →

Insurance plans in this area (ZIP 60061)

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Reviews

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Frequently asked questions

What is the standard ID for MICHAEL R BOURBON (LCSW) in the U.S.?
In the U.S., MICHAEL R BOURBON (LCSW) is identified by NPI 1316012537.
Is MICHAEL R BOURBON (LCSW) currently accepting referrals based on NPI status?
Registry metadata lists MICHAEL R BOURBON (LCSW) as active.
What services align with MICHAEL R BOURBON (LCSW)'s listing?
MICHAEL R BOURBON (LCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MICHAEL R BOURBON (LCSW) tied to Vernon Hills, Illinois?
If you are local to Vernon Hills, Illinois, MICHAEL R BOURBON (LCSW) may be relevant to your search.
Why is information missing for MICHAEL R BOURBON (LCSW)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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