Kathleen Callaghan Jacob, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149005843 Issued in IL

Practice address

935 Curtiss St
Suite 7
Downers Grove, IL 60515-4763

Phone

(773) 787-7763

NPI assigned

Jan 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Affiliates in Counseling LLC

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1003868472
  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1700865128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N NEW ENGLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073301",
            "telephone_number": "630-534-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 CURTISS ST",
            "address_2": "SUITE 7",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154763",
            "telephone_number": "773-787-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "KATHLEEN",
        "middle_name": "CALLAGHAN",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149005843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01621910",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J Hart & Associates
• Jenna Jablonski
• Eric Jackson, D.D.S.
• Kendal'Spirit Jackson, LPC
• Shelby Ellis Jackson, DMD
• Laura L Jacobs, RDH
• Mark M Jacquot, O.D.
• Maliha Jamal Jaffery, MD
• Stephen Thomas Jagielo, DDS
• Martha P Jaimes, DMD

• Clinical Social Worker in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.