Active NPI
Kirsten Refvik, LCSW
- Clinical Social Worker
- Streamwood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149015103
- Practice address
- 105 Jill LN
Streamwood, IL 60107-1146 - Phone
- (336) 420-3367
- NPI assigned
- Mar 2, 2020
- Last updated
- Mar 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149015103 | IL | Primary |
Addresses
Primary practice location
105 Jill LN
Streamwood, IL 60107-1146
Mailing address
105 Jill LN
Streamwood, IL 60107-1146
Phone (336) 420-3367
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Jamestown LN
Lincolnshire, IL 60069-2119
Phone (224) 543-7100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149015103 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Clinical | Current | Accepting new patients |
Locations
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
3450 Oakton St
Ste 300
Skokie, IL 60076
Networks
- IL PPO Downstate
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IL HMO C-SNP
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Alden-Long Grove Rehabilitation and Health Care Center, Inc. | Skilled nursing facility | W-2 Managing Employee (100%) | Mar 13, 2017 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Long Grove, IL
- NPI 1972590230
W-2 Managing Employee
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1003440769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 JILL LN",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "601071146",
"telephone_number": "336-420-3367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 JILL LN",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "601071146",
"telephone_number": "336-420-3367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REFVIK",
"first_name": "KIRSTEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149015103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Streamwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.