Individual provider Active NPI

Amanda Hutera

  • Clinical Social Worker
  • Mokena, IL
National Provider Identifier
1154073286
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012027 Issued in IL
Practice address
19805 S la Grange Rd
Mokena, IL 60448-8348
Phone
(708) 938-3378
NPI assigned
Jan 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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 149012027 IL Primary

Addresses

Primary practice location

19805 S la Grange Rd
Mokena, IL 60448-8348

Mailing address

PO Box 57085
Chicago, IL 60657-7345

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
I20220629000680 IL Practitioner - Clinical Social Worker 2769875046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
KCS Counseling, LTDGroup PAC ID 1254787161, 2 clinicians
Three Point Healthcare LLCGroup PAC ID 9133484694, 26 clinicians

Practice addresses (Care Compare)

13550 S Route 30
Suite 204B
Plainfield, IL 60544-5688
Phone (630) 674-3477

19805 S la Grange Rd
Mokena, IL 60448-8348
Phone (708) 938-3378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149012027ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KCS Counseling, LTD. Clinical CurrentSince Sep 18, 2024 Accepting new patients

Locations

123 W Washington St
Ste 216
Oswego, IL 60543
Phone (630) 465-0671

13550 S Route 30
Ste 204B
Plainfield, IL 60544
Phone (331) 264-6002

Organizations & group practices 2

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": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1154073286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57085",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19805 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488348",
            "telephone_number": "708-938-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTERA",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.