Autumn Kulchawik

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

265 Stebbings CT Ste 1
Bradley, IL 60915-1282

Phone

(602) 919-1845

NPI assigned

Sep 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1700333903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 LAKE SUPERIOR RD APT 108",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463836742",
            "telephone_number": "602-919-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 STEBBINGS CT STE 1",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609151282",
            "telephone_number": "602-919-1845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 W Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701568",
            "country_code": "US",
            "telephone_number": "815-432-5241",
            "fax_number": "815-432-4537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULCHAWIK",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Kempes
• Michael Preston King, OTR/L
• Philip Kirk, LPC
• Kline Chiropractic LTD (Bradley Chiropractic)
• David Carl Kline, D.C.
• Rebecca Kvasnicka, MOT, OTR/L
• Brenda Gayle Ladson, LCSW
• Erica Lambert
• Jacqueline Carol Lane
• Donald Thaddeus Latocha, M.A. L.C.P.C.

• Social Worker in Bradley, IL
• Providers in Bradley, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.