Kristine Bukala, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019565 Issued in IL

Practice address

25224 W Eames St Ste C
Channahon, IL 60410-5256

Phone

(815) 467-8181

NPI assigned

Jun 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Counseling and Coaching of Illinois LLC 19 clinicians

Gianan Health, PLLC 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alliance Counseling & Coaching of Illinois, LLC

  • Professional Counselor
  • Channahon, IL
  • NPI 1063867257

  IL

  Medicare reassignment Care Compare group NPD
• Gianan Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolingbrook, IL
  • NPI 1467201210

  IL

  Medicare reassignment Care Compare group
• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931

  Clinical, IL

  Medicare reassignment NPD
• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268

  IL

  Medicare reassignment NPD
• Morris Hospital

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511
  NPD
• Morris Hospital

  • Health Service Clinic/Center
  • Morris, IL
  • NPI 1376658658
  NPD
• Morris Hospital

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  NPD

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1336679455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25224 E EAMES ST",
            "address_2": "SUITE C",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "60410",
            "telephone_number": "815-467-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25224 W EAMES ST STE C",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604105256",
            "telephone_number": "815-467-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKALA",
        "first_name": "KRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019565",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150015098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Bojak
• Kelly Bragdon, LPC, NCC
• Kevin Breen, D.D.S.
• Gayle C Briley, RDH
• Timothy Brown, PSY.D.
• Natalie K Bunton, CCC-SLP/L
• Lisa M Burns, LCSW
• Regina Burrs, LSW
• Karli Carter, SLP
• Nuzhat Chalisa, MD

• All providers in Channahon, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.