Kelsey Bergsieker
Individual provider Active NPI Social Worker · Dixon, IL
NPI 1679945646 · NPPES record last updated Oct 29, 2015
Key facts
- NPI
- 1679945646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 1011 S Hennepin Ave
Dixon, IL 61021-4023 - Phone
- (815) 228-8983
- NPI assigned
- Oct 29, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
1011 S Hennepin Ave
Dixon, IL 61021-4023
Mailing address
1011 S Hennepin Ave
Dixon, IL 61021-4023
Phone (815) 228-8983
Other providers in Dixon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.