Kathleen Erin Eccles, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013183 Issued in IL

Practice address

3751 N Pulaski Rd
Chicago, IL 60641-3136

Phone

(773) 463-1200

Fax

(773) 463-1201

NPI assigned

Aug 10, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathleen Erin Debock Former name

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Thrive Therapeutic Services, LLC

  • Clinical Social Worker
  • Mount Prospect, IL
  • NPI 1568694578
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1104058114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E PROSPECT AVE",
            "address_2": "STE 214",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600563396",
            "telephone_number": "773-750-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413136",
            "telephone_number": "773-463-1200",
            "fax_number": "773-463-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLES",
        "first_name": "KATHLEEN",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DEBOCK",
            "middle_name": "ERIN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ebw Physical Therapy LLC
• Ec Care Dental Center,Inc.
• Eccentric Learning Laboratories, LLC
• Ain O Eccles
• Jacob David Eccles, MD, PHD
• Julia Megan Ecclestone, M.A., CCC-SLP
• Ech Nutrition LLC
• Anthony Echauz
• Donna Echevarria, PA-C
• Fidel Echevarria, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.