Patrick Ryan Keclik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.023250 Issued in IL

Practice address

1 E Northwest Hwy Ste 201
Palatine, IL 60067-1700

Phone

(847) 908-8700

NPI assigned

Apr 29, 2021

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

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, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fash Counseling Inc.

  • Mental Health Counselor
  • Bolingbrook, IL
  • NPI 1346766250
  Medicare reassignment
• Illuminate Therapy and Wellness, S-Corp

  • Mental Health Counselor
  • Palatine, IL
  • NPI 1598398794
  NPD

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1861075673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 N KATHERINE LN",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011593",
            "telephone_number": "847-757-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E NORTHWEST HWY STE 201",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600671700",
            "telephone_number": "847-908-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECLIK",
        "first_name": "PATRICK",
        "middle_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Anderson P.C.
• Amanda Margaret Karm, D.C.
• Julia Kashul
• Michele Pamela Kazmier, MA, LCPC
• Elizabeth Keane, RD, LDN
• Katarzyna Kedryna, M.A
• Rebecca S Keith, MD
• Megan Marie Kelly, OTR/L
• Derreck Keopanya
• Jack D. Keyser, D.C

• Clinical Social Worker in Palatine, IL
• Providers in Palatine, 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 27, 2021; 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.