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IAN VICTOR PROVO
NPI 1235614124
Social Worker - Clinical in Rockford, IL

Active since September 26, 2018PECOS EnrolledAccepts Medicare Assignment
1126 POST DR, ROCKFORD, IL 61108(815) 229-3738 Get Directions Write a Review

NPPES record last updated: September 26, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ian Victor Provo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IAN VICTOR PROVO (NPI 1235614124) is an individual clinical provider in Rockford, Illinois, licensed in Illinois (149006049) and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1235614124
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameIAN VICTOR PROVO
Location Address1126 POST DRRockford, IL 61108-4251
Mailing Address1126 Post DrRockford, IL 61108-4251 · (815) 229-3738
Phone(815) 229-3738
Sole ProprietorYes
Medical School CMSOtherGraduated 1991
Enumeration DateSeptember 26, 2018
✔ NPI 1235614124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149006049
Definition
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.
1126 POST DR, Rockford, IL 61108
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Other Names 1

Professional Name (2)Mr. Ian Victor Provo Msw, Lcsw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ian Victor Provo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254710676
PECOS Enrollment IDI20220615001376, I20220722001831
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ian Provo's NPI number?

The NPI number for Ian Provo is 1235614124. It was assigned to this individual provider in the NPPES registry on September 26, 2018. The provider is also known as Mr. Ian Victor Provo Msw, Lcsw.

Where is Ian Provo located?

Ian Provo practices at 1126 Post Dr, Rockford, IL 61108. The listed phone number is (815) 229-3738.

What is Ian Provo's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ian Provo enrolled in Medicare?

Yes. Ian Provo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ian Provo was last updated on September 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.