Individual provider Active NPI

Michelle M Kator, L.C.S.W.

  • Clinical Social Worker
  • Park Ridge, IL
National Provider Identifier
1780775460
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149007020 Issued in IL
Practice address
2604 Dempster St
Suite 510
Park Ridge, IL 60068-8412
Phone
(847) 824-1235
Fax
(847) 824-2386
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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 149007020 IL Primary

Addresses

Primary practice location

2604 Dempster St
Suite 510
Park Ridge, IL 60068-8412

Mailing address

1580 N. Northwest Hwy
Suite 3110
Park Ridge, IL 60068
Phone (847) 824-1235

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160331001257 IL Practitioner - Clinical Social Worker 3678870938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinical Psychologists, LTDGroup PAC ID 4981991031, 4 clinicians

Practice addresses (Care Compare)

1580 N Northwest Hwy
Suite 311D
Park Ridge, IL 60068-1466
Phone (847) 824-1235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149007020ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinical Psychologists, LTD Clinical CurrentSince Jan 4, 2016 Accepting new patients

Locations

1580 N Northwest Hwy
Ste 311D
Park Ridge, IL 60068
Phone (847) 824-1235

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1780775460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 N. NORTHWEST HWY",
            "address_2": "SUITE 3110",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-824-1235",
            "fax_number": "847-824-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 510",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-824-1235",
            "fax_number": "847-824-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATOR",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149007020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.