Individual provider Active NPI

Kristin Marko, LCSW

  • Clinical Social Worker
  • Ottawa, IL
National Provider Identifier
1528967577
Registry record updated Nov 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149031802 Issued in IL
Practice address
747 E Etna Rd Ste a
Ottawa, IL 61350-3777
Phone
(815) 993-1614
NPI assigned
Nov 4, 2026
Last updated
Nov 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2026

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 149031802 IL Primary

Addresses

Primary practice location

747 E Etna Rd Ste a
Ottawa, IL 61350-3777

Mailing address

747 E Etna Rd Ste a
Ottawa, IL 61350-3777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793750400000",
    "number": "1528967577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E ETNA RD STE A",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E ETNA RD STE A",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503777",
            "telephone_number": "815-993-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKO",
        "first_name": "KRISTIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149031802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.