Individual provider Active NPI

Kaleena Williams

  • Clinical Social Worker
  • Galesburg, IL
National Provider Identifier
1679919542
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015718 Issued in IL
Practice address
834 North Seminary Street
Suite 405
Galesburg, IL 61401
Phone
(309) 344-9444
Fax
(309) 717-0124
NPI assigned
May 17, 2013
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 149015718 IL Primary

Addresses

Primary practice location

834 North Seminary Street
Suite 405
Galesburg, IL 61401

Mailing address

2323 Windish Dr
Galesburg, IL 61401-9780

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
I20130517000345 IL Practitioner - Clinical Social Worker 9133366735 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mary Medical CenterGroup PAC ID 8628038015, 52 clinicians

Practice addresses (Care Compare)

3315 N Seminary St
Suite 206 207 208
Galesburg, IL 61401-1251
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 343-5114

695 N Kellogg St
Osf Promptcare Galesburg
Galesburg, IL 61401-2807
Phone (309) 343-1000

834 N Seminary
Suite 401 Osf Healthcare Medical Group Ga
Galesburg, IL 61401-0500
Phone (309) 446-3305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015718ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Reena Jabamoni MDSC Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System CurrentSince Oct 1, 2017 Accepting new patients
St Mary Medical Center CurrentSince Aug 13, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2022 Accepting new patients
Osf Healthcare System CurrentSince Oct 26, 2016 Accepting new patients
St. Mary Medical Center CurrentSince Aug 13, 2023 Accepting new patients
Osf Healthcare System CurrentSince Oct 26, 2016 Accepting new patients
Osf Healthcare System Current Accepting new patients
St Mary Medical Center Past Accepting new patients
Vios Fertility Institute Chicago Past Accepting new patients
St Mary Medical Center PastSince Mar 24, 2024 Accepting new patients

Locations

3315 N Seminary St
Ste 206
Galesburg, IL 61401
Phone (309) 344-1000

3375 N Seminary St
Galesburg, IL 61401
Phone (309) 343-5114

834 N Seminary St
Ste 405
Galesburg, IL 61401
Phone 3093435114 ext. 61072

1585 N Barrington Rd
Ste 401
Hoffman Estates, IL 60169
Phone (847) 843-7090

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1679919542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 NORTH SEMINARY STREET",
            "address_2": "SUITE 405",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-344-9444",
            "fax_number": "309-717-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KALEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.