Individual provider Active NPI

Kristine Bermingham, MSW, LCSW

  • Clinical Social Worker
  • Channahon, IL
National Provider Identifier
1083467922
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149029701 Issued in IL
Practice address
25224 W Eames St Ste D
Channahon, IL 60410-5256
Phone
(815) 467-8181
NPI assigned
Apr 10, 2024
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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 149029701 IL Primary

Addresses

Primary practice location

25224 W Eames St Ste D
Channahon, IL 60410-5256

Mailing address

25816 S Woodrush Way
Channahon, IL 60410-8774
Phone (708) 692-5747

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
I20260625000800 IL Practitioner - Clinical Social Worker 4385117985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25224 E Eames St
Channahon, IL 60410-5256

25224 W Eames St
Channahon, IL 60410-5215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149029701ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Counseling & Coaching of Illinois, PLLC CurrentSince Apr 14, 2024 Accepting new patients

Locations

25224 W Eames St
Channahon, IL 60410
Phone (815) 467-8181

25224 W Eames St
Ste D
Channahon, IL 60410
Phone (815) 467-8181

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, 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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1083467922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25816 S WOODRUSH WAY",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604108774",
            "telephone_number": "708-692-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25224 W EAMES ST STE D",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604105256",
            "telephone_number": "815-467-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMINGHAM",
        "first_name": "KRISTINE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149029701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Channahon, IL

Sources for this page

Verify at the official NPI Registry.