Active NPI
Kim Neilson, LSW
- Social Worker
- Lake in the Hills, IL
National Provider Identifier
1073485264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.106773
- Practice address
- 9 Crystal Lake Rd Ste 250
Lake in the Hills, IL 60156-1296 - Phone
- (847) 221-5622
- NPI assigned
- Sep 18, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.106773 | IL | Primary |
Addresses
Primary practice location
9 Crystal Lake Rd Ste 250
Lake in the Hills, IL 60156-1296
Mailing address
975 Blackberry CT
Lake in the Hills, IL 60156-4601
Phone (773) 459-7061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.106773 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1073485264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 BLACKBERRY CT",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601564601",
"telephone_number": "773-459-7061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 CRYSTAL LAKE RD STE 250",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601561296",
"telephone_number": "847-221-5622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEILSON",
"first_name": "KIM",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.106773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake in the Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.