Individual provider Active NPI

Kathryn Nixon Foster, LCSW

  • Clinical Social Worker
  • Waukegan, IL
National Provider Identifier
1043792823
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018341 Issued in IL
Practice address
329 N Genesee St
Waukegan, IL 60085-4205
Phone
(847) 623-1730
Fax
(847) 623-1733
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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 149.018341 IL Primary

Addresses

Primary practice location

329 N Genesee St
Waukegan, IL 60085-4205

Mailing address

329 N Genesee St
Waukegan, IL 60085-4205
Phone (847) 623-1730

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
I20231009002646 IL Practitioner - Clinical Social Worker 4981059136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1113 S Milwaukee Ave
Suite 104
Libertyville, IL 60048-3759
Phone (847) 367-5991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.018341ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Youth & Family Counseling CurrentSince Aug 26, 2023 Accepting new patients
Arden Shore Child and Family Services Past Accepting new patients

Locations

1113 S Milwaukee Ave
Ste 104
Libertyville, IL 60048
Phone (847) 367-5991

Organizations & group practices 2

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1043792823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N GENESEE ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854205",
            "telephone_number": "847-623-1730",
            "fax_number": "847-623-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 N GENESEE ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854205",
            "telephone_number": "847-623-1730",
            "fax_number": "847-623-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "KATHRYN",
        "middle_name": "NIXON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.