Individual provider Active NPI

Katie Elaine Schlichting, L.C.S.W.

  • Clinical Social Worker
  • Antioch, IL
National Provider Identifier
1265742902
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149014617 Issued in IL
Practice address
974 Main St
Antioch, IL 60002-1537
Phone
(224) 595-1843
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.010349 IL
Clinical Social Worker 1041C0700X 149014617 IL Primary

Addresses

Primary practice location

974 Main St
Antioch, IL 60002-1537

Mailing address

974 Main St
Antioch, IL 60002-1537
Phone (224) 595-1843

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
I20111004000577 IL Practitioner - Clinical Social Worker 7214109867 Practice locations: Antioch, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

974 Main St
Antioch, IL 60002-1537
Phone (224) 595-1843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.010349ILMDSocial Worker
149014617ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1265742902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021537",
            "telephone_number": "224-595-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021537",
            "telephone_number": "224-595-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICHTING",
        "first_name": "KATIE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.010349",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.