Kenneth Terry Breitwiser, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013342 Issued in IL

Practice address

50 East Washington
St. James Cathedral Counseling Center
Chicago, IL 60602-2142

Phone

(312) 252-9500

Fax

(312) 337-9243

NPI assigned

Nov 21, 2005

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1700869104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 W RASCHER AVE",
            "address_2": "#1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401205",
            "telephone_number": "773-561-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EAST WASHINGTON",
            "address_2": "ST. JAMES CATHEDRAL COUNSELING CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022142",
            "telephone_number": "312-252-9500",
            "fax_number": "312-337-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITWISER",
        "first_name": "KENNETH",
        "middle_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy James Breider, MD
• Faye Baulch Breining, AM
• Lauren Louise Breit, LCPC, CADC, NCC, CST
• Natalie R Breitmeyer, LCPC, R-DMT
• Damien Breitsprecher
• Rachel Anne Breivald, NP
• Melissa Brelie, CNA
• Jennifer Bremer, M.D.
• Jennifer Brenczewski, PT
• Brenda T. Thompson

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 May 24, 2010; 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.