Elizabeth Ann Kimura, MA, LPC, NCC, MT-BC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178018166 Issued in IL

Practice address

1737 N Campbell Ave Unit 1S
Chicago, IL 60647-5205

Phone

(847) 341-7993

NPI assigned

Jun 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Collaborative Counseling Group of Illinois PLLC

  • Clinical Social Worker
  • Mundelein, IL
  • NPI 1730810318
  NPD (past)
• Synaptx, LTD

  • Point of Service
  • Crystal Lake, IL
  • NPI 1669637344
  NPD (past)

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1851705123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W GREGORY ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401377",
            "telephone_number": "478-341-7993",
            "fax_number": "815-788-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 N CAMPBELL AVE UNIT 1S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475205",
            "telephone_number": "847-341-7993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1799 Kings Gate Ln",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600142906",
            "country_code": "US",
            "telephone_number": "815-276-7786",
            "fax_number": "815-788-1321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMURA",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "MA, LPC, NCC, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "IL",
            "license": "11259",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178018166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Christine Kimmig, MD
• Clare Delaney Kimmis, MA
• Isabella Kimrey, LPC
• Kims Modern Pharmacy Inc
• Shannon Kimsey, FPA, APRN
• Robert Kimura, M.D.
• Kin Therapy Collective PLLC
• Karen Kinahan
• Patricia C. Kinahan, MSN, FNP-BC
• Korinne Alice Kincaid, RN

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.