Individual provider Active NPI

Katherine McBroome, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1700240777
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013574 Issued in IL
Practice address
4803 N Bell Ave
3N
Chicago, IL 60625-1943
Phone
(773) 531-8068
NPI assigned
Apr 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.013574 IL Primary

Addresses

Primary practice location

4803 N Bell Ave
3N
Chicago, IL 60625-1943

Mailing address

4803 N Bell Ave
3N
Chicago, IL 60625-1943
Phone (773) 531-8068

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
I20241011000309 IL Practitioner - Clinical Social Worker 8022540327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4753 N Broadway St
Suite 403
Chicago, IL 60640-7910
Phone (779) 368-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013574ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care Therapy Services of Illinois PC Clinical CurrentSince Mar 15, 2025 Accepting new patients
KP Counseling LTD Clinical CurrentSince Sep 1, 2024 Accepting new patients
Optum Behavioral Care Therapy Services of Illinois PC Clinical CurrentSince Mar 15, 2025 Accepting new patients

Locations

180 N Michigan Ave
Ste 410
Chicago, IL 60601
Phone (773) 699-6079

4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780

12151 Regency Pkwy
Ste 12189
Huntley, IL 60142
Phone (779) 368-0660

Interoperability endpoints

  • Direct secure messaging: katherine.mcbroome.1@28621.direct.athenahealth.com

Organizations & group practices 3

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1700240777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 N BELL AVE",
            "address_2": "3N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251943",
            "telephone_number": "773-531-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 N BELL AVE",
            "address_2": "3N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251943",
            "telephone_number": "773-531-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBROOME",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.