Individual provider Active NPI

Todd Kestin, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1093993529
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012869 Issued in IL
Practice address
899 Skokie Blvd
Suite 204
Northbrook, IL 60062-4019
Phone
(847) 323-3539
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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 149.012869 IL Primary

Addresses

Primary practice location

899 Skokie Blvd
Suite 204
Northbrook, IL 60062-4019

Mailing address

899 Skokie Blvd Ste 204
Suite 204
Northbrook, IL 60062-4022

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.012869ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1093993529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 SKOKIE BLVD STE 204",
            "address_2": "SUITE 204",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 SKOKIE BLVD",
            "address_2": "SUITE 204",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624019",
            "telephone_number": "847-323-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTIN",
        "first_name": "TODD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.