Look up the most recent NPI and PECOS records

Caroline Wysgalla

Social Worker

Behavioral Health & Social Service Providers

1165 N Clark St Ste 305, Chicago, IL 60610-7862

PECOS Enrollment

Based on the most recent information from CMS, provider Caroline Wysgalla is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1417601550
Provider Type
Individual
Full Name
Wysgalla, Caroline
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
2/8/2022
Last Updated
4/3/2025

Contact Information

Practice Location

1165 N Clark St Ste 305, Chicago, IL 60610-7862

(312) 880-9913

(844) 787-9891

Mailing Location

1165 N Clark St Ste 305, Chicago, IL 60610-7862

(312) 880-9913

(844) 787-9891

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149.028147 Illinois

Caroline Wysgalla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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