Individual provider Active NPI

Kamille Thompson, LMFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1669231973
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001727 Issued in IL
Practice address
25 E Washington St
Chicago, IL 60602-1708
Phone
(312) 298-9846
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.001727 IL Primary

Addresses

Primary practice location

25 E Washington St
Chicago, IL 60602-1708

Mailing address

25 E Washington St Ste 1021
Chicago, IL 60602-1710
Phone (312) 298-9846

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
I20240515003399 IL Practitioner - Marriage and Family Therapist 3678914090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
166.001727ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Apr 22, 2024 Accepting new patients
County of Lake CurrentSince Apr 22, 2024 Accepting new patients
Pinnacle Counseling, LLC Marriage & Family Therapist PastSince Mar 24, 2024 Accepting new patients

Locations

3004 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8120

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

Organizations & group practices 4

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": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1669231973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1021",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021710",
            "telephone_number": "312-298-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-298-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KAMILLE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.