Kathleen Bandera, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.007662 Issued in IL

Practice address

21569 Sutton Dale LN
Frankfort, IL 60423-2234

Phone

(312) 403-7977

NPI assigned

Mar 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

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.

• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1619735875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21569 SUTTON DALE LN",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232234",
            "telephone_number": "312-403-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21569 SUTTON DALE LN",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232234",
            "telephone_number": "312-403-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDERA",
        "first_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.007662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rubina Siddiq Baig, MD
• Alyssa Baker, MS RD
• Erin Baldauf, IBCLC
• Erika Ball, FNP-C
• Jennifer Lynn Banas, SLP
• Alexis Marie Banks, RD, LDN
• Baobab Healthcare Services, Inc.
• Sarah Barber
• Danielle Barker, NP
• Michelle M Barrera, DDS

• Clinical Social Worker in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.