Individual provider Active NPI

Tracey Lipsig Kite, LCSW

  • Clinical Social Worker
  • Northbrook, IL
National Provider Identifier
1629029624
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007083 Issued in IL
Practice address
3000 Dundee Rd
Northbrook, IL 60062-2422
Phone
(847) 901-3488
Fax
(847) 901-3889
NPI assigned
May 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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 149.007083 IL
Clinical Social Worker 1041C0700X 149007083 IL Primary

Addresses

Primary practice location

3000 Dundee Rd
Northbrook, IL 60062-2422

Mailing address

1516 Sequoia TRL
Glenview, IL 60025-2019
Phone (847) 901-3488

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
I20050614001149 IL Practitioner - Clinical Social Worker 3678517232 Practice locations: Northbrook, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1516 Sequoia TRL
Glenview, IL 60025-2019

3000 Dundee Rd
Suite 111
Northbrook, IL 60062-2424
Phone (847) 901-3488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.007083ILMDSocial Worker
149007083ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TLKG PLLC Clinical CurrentSince Nov 17, 2024 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": "1147564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1629029624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 SEQUOIA TRL",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252019",
            "telephone_number": "847-901-3488",
            "fax_number": "847-901-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622422",
            "telephone_number": "847-901-3488",
            "fax_number": "847-901-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITE",
        "first_name": "TRACEY",
        "middle_name": "LIPSIG",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.007083",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.