Individual provider Active NPI

Loree Kinsella, LSW

  • Social Worker
  • Evergreen Park, IL
National Provider Identifier
1720775786
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.103717 Issued in IL
Practice address
3317 W 95TH St Ste 101
Evergreen Park, IL 60805-2243
Phone
(708) 529-3011
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.103717 IL Primary

Addresses

Primary practice location

3317 W 95TH St Ste 101
Evergreen Park, IL 60805-2243

Mailing address

9347 S Richmond Ave
Evergreen Park, IL 60805-2423

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
150.103717ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1720775786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9347 S RICHMOND AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 W 95TH ST STE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052243",
            "telephone_number": "708-529-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "LOREE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.103717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.