Individual provider Active NPI

Kimberly Walton, L.C.S.W.

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1184812059
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.012268 Issued in IL
Practice address
1122 Westgate St
#204
Oak Park, IL 60301-1170
Phone
(708) 214-4134
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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 149.012268 IL Primary

Addresses

Primary practice location

1122 Westgate St
#204
Oak Park, IL 60301-1170

Mailing address

1122 Westgate St
#204
Oak Park, IL 60301-1170
Phone (708) 214-4134

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
149.012268ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
More Abundant Living Institute, P.C. Clinical PastSince Oct 1, 2009 Accepting new patients
Earnest Webb, PC Past Accepting new patients

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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1184812059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 WESTGATE ST",
            "address_2": "#204",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011170",
            "telephone_number": "708-214-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 WESTGATE ST",
            "address_2": "#204",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011170",
            "telephone_number": "708-214-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "KIMBERLY",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.012268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.