Individual provider Active NPI

Kate Pellish

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1174281612
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020887 Issued in IL
Practice address
4126 Greenwood St
Skokie, IL 60076-1944
Phone
(847) 840-3862
NPI assigned
Dec 1, 2021
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 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 149.020887 IL Primary

Addresses

Primary practice location

4126 Greenwood St
Skokie, IL 60076-1944

Mailing address

4126 Greenwood St
Skokie, IL 60076-1944
Phone (847) 840-3862

Other practice location 1

450 Skokie Blvd Ste 503
Northbrook, IL 60062-7913
Phone (847) 497-8378

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.020887ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Leigh Neiman Weisz, PC Clinical CurrentSince Dec 1, 2021 Accepting new patients

Locations

450 Skokie Blvd
Ste 503
Northbrook, IL 60062
Phone (847) 220-7707

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1174281612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 GREENWOOD ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761944",
            "telephone_number": "847-840-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 GREENWOOD ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761944",
            "telephone_number": "847-840-3862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Skokie Blvd Ste 503",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600627913",
            "country_code": "US",
            "telephone_number": "847-497-8378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLISH",
        "first_name": "KATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.