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MIXI LOPEZ-CORBIN
NPI 1417572603
Social Worker - Clinical in Chicago, IL

Active since June 12, 2020Opted out of Medicare · through Jun 30, 2028
6501 S PROMONTORY DR, CHICAGO, IL 60649(800) 770-2232 Get Directions Write a Review

NPPES record last updated: July 21, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jul 21, 2020, Jun 12, 2020 (2 updates tracked since 2020).

About Mixi Lopez-corbin NPPES

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

MIXI LOPEZ-CORBIN (NPI 1417572603) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (149.022368) and active in the NPI registry since June 2020. She has opted out of Medicare through June 30, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1417572603
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMIXI LOPEZ-CORBIN
Location Address6501 S PROMONTORY DRChicago, IL 60649-1003
Mailing Address1500 Sherman Ave Apt 419Evanston, IL 60201-4439 · (571) 278-5097
Phone(800) 770-2232
Sole ProprietorNo
Enumeration DateJune 12, 2020
Last NPPES UpdateJuly 21, 20202 updates tracked since enumeration
NPPES CertifiedJuly 21, 2020
✔ NPI 1417572603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in IL · 149.022368✔ Licensed in MA · 122589-SW-LICSW
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.
6501 S PROMONTORY DR, Chicago, IL 60649
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mixi Lopez-corbin has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 30, 2026 through June 30, 2028.

Opt-Out Effective DateJune 30, 2026
Opt-Out In Effect ThroughJune 30, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLLY SWENSON MURGATROYD DPT
Physical Therapist (Pediatrics)
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 256-5776
ZAKIYA GILLIAM M.S.
Developmental Therapist
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 753-8635
ARIANNA TIMKO PSYD
Psychologist (Clinical)
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 256-5723
CAITLIN LEVEY CACIOPPO
Dietitian, Registered
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (908) 675-6990
SYDNEY PARTINGTON DPT
Physical Therapist (Pediatrics)
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 363-6700
JESSICA LEJEUNE DPT
Physical Therapist
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (763) 363-6700
DANIELLE DREWS DPT
Physical Therapist
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 363-6700
MISS CAILEY RAE HOWARD RN
Registered Nurse
6501 S PROMONTORY DR
CHICAGO, IL 60649
Cook County (773) 363-6700

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 Mixi Lopez-corbin's NPI number?

The NPI number for Mixi Lopez-corbin is 1417572603. It was assigned to this individual provider in the NPPES registry on June 12, 2020.

Where is Mixi Lopez-corbin located?

Mixi Lopez-corbin practices at 6501 S Promontory Dr, Chicago, IL 60649. The listed phone number is (800) 770-2232.

What is Mixi Lopez-corbin's specialty?

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

Is Mixi Lopez-corbin enrolled in Medicare?

No. Mixi Lopez-corbin has opted out of Medicare through June 30, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mixi Lopez-corbin was last updated on July 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.