Individual provider Active NPI

Kathleen Goldman

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1023593464
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020441 Issued in IL
Practice address
3380 Lacrosse LN Ste 101
Naperville, IL 60564-8528
Phone
(847) 636-8226
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.020441 IL Primary

Addresses

Primary practice location

3380 Lacrosse LN Ste 101
Naperville, IL 60564-8528

Mailing address

3380 Lacrosse LN Ste 101
Naperville, IL 60564-8528
Phone (847) 636-8226

Other practice location 1

3380 LaCrosse Ln Ste 101
Naperville, IL 60564-8528
Phone (847) 636-8226

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508002247 IL Practitioner - Clinical Social Worker 0941542195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 E State St
Geneva, IL 60134-2361
Phone (847) 636-8226

621 Carlisle CT
Sugar Grove, IL 60554-9808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.020441ILMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1023593464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 LACROSSE LN STE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648528",
            "telephone_number": "847-636-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 LACROSSE LN STE 101",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648528",
            "telephone_number": "847-636-8226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3380 LaCrosse Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605648528",
            "country_code": "US",
            "telephone_number": "847-636-8226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.