Individual provider Active NPI

Doris W. Klinkhamer, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1386734671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1165 N Clark St
Suite 413
Chicago, IL 60610-2702
Phone
(312) 719-1926
NPI assigned
Oct 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 IL Primary

Addresses

Primary practice location

1165 N Clark St
Suite 413
Chicago, IL 60610-2702

Mailing address

4449 N California Ave
Second Floor
Chicago, IL 60625-3803
Phone (312) 719-1926

Other identifiers 1

IdentifierTypeStateIssuer
01633160OtherILBC/BS PPO PROVIDER NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Klinkhamer Counseling Inc. Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386734671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4449 N CALIFORNIA AVE",
            "address_2": "SECOND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253803",
            "telephone_number": "312-719-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 N CLARK ST",
            "address_2": "SUITE 413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102702",
            "telephone_number": "312-719-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKHAMER",
        "first_name": "DORIS",
        "middle_name": "W.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PPO PROVIDER NUMBER",
            "identifier": "01633160",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.