Individual provider Active NPI

Reesa Kizior

  • Clinical Social Worker
  • Lisle, IL
National Provider Identifier
1700518719
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007703 Issued in IL
Practice address
3033 Ogden Ave Ste 210
Lisle, IL 60532-1976
Phone
(877) 443-7030
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 149007703 IL Primary

Addresses

Primary practice location

3033 Ogden Ave Ste 210
Lisle, IL 60532-1976

Mailing address

3033 Ogden Ave Ste 210
Lisle, IL 60532-1976
Phone (877) 443-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149007703ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1700518719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321976",
            "telephone_number": "877-443-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 OGDEN AVE STE 210",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321976",
            "telephone_number": "877-443-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZIOR",
        "first_name": "REESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.