Individual provider Active NPI

Michelle Kilimnik, LCSW

  • Clinical Social Worker
  • Buffalo Grove, IL
National Provider Identifier
1083376834
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019650 Issued in IL
Practice address
1100 W Lake Cook Rd Ste 210
Buffalo Grove, IL 60089-1929
Phone
(847) 979-0268
NPI assigned
Oct 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05797300 NJ
Clinical Social Worker 1041C0700X 149019650 IL Primary

Addresses

Primary practice location

1100 W Lake Cook Rd Ste 210
Buffalo Grove, IL 60089-1929

Mailing address

1231 Grant St # 1
Evanston, IL 60201-2614

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
I20231202000587 IL Practitioner - Clinical Social Worker 6204284151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Progressive Psychological Healthcare SCGroup PAC ID 8527366939, 10 clinicians

Practice addresses (Care Compare)

750 W Lake Cook Rd
Suite 190
Buffalo Grove, IL 60089-2084
Phone (847) 979-0268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05797300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Psychological Healthcare, S.C. CurrentSince Sep 10, 2023 Accepting new patients
Marianna Tsaran MD SC PastSince Oct 10, 2021 Accepting new patients
In Home Health, LLC Past Accepting new patients

Locations

750 W Lake Cook Rd
Ste 190
Buffalo Grove, IL 60089
Phone (847) 979-0268

1100 W Lake Cook Rd
Ste 130
Buffalo Grove, IL 60089
Phone (847) 439-5359

1100 W Lake Cook Rd
Ste 210
Buffalo Grove, IL 60089
Phone (847) 979-0268

2551 N Clark St
Ste 300
Chicago, IL 60614
Phone (847) 979-0268

Organizations & group practices 3

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": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1083376834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 GRANT ST # 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W LAKE COOK RD STE 210",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891929",
            "telephone_number": "847-979-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILIMNIK",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05797300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.