Kristen Widing, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150.104083 Issued in IL

Practice address

1136 S Delano CT W Ste B201
Chicago, IL 60605-3734

Phone

(773) 377-5577

NPI assigned

Dec 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tides of Totality Therapeutics Inc

  • Clinical Social Worker
  • Northfield, IL
  • NPI 1891505848
  NPD Authorized official

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1053959270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 WARRINGTON LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142020",
            "telephone_number": "815-505-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 S DELANO CT W STE B201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053734",
            "telephone_number": "773-377-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDING",
        "first_name": "KRISTEN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.104083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Widaman
• Thomas A Widell, M.D.
• Ronald Roger Widen, DDS
• Shanna Marie Widera, RN, APN
• Abbie Claire Widing, RD
• Victoria Widlak, PHARMD
• Annie Laurie Widlicka, MS, RD, LDN
• Kassie Widmyer, LCSW
• Olivia Widner, MC, LPC
• Katherine Wido

• Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.