Individual provider Active NPI

William R. Kinnaird Jr., MSW, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1902903248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
VA Jesse Brown Medical Center, 820 S. Damen Ave.
10514
Chicago, IL 60612
Phone
(312) 569-6943
Fax
(312) 569-8083
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

VA Jesse Brown Medical Center, 820 S. Damen Ave.
10514
Chicago, IL 60612

Mailing address

1163 S Kenilworth Ave
Oak Park, IL 60304-1944
Phone (708) 386-6183

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
149-000474ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902903248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 S KENILWORTH AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041944",
            "telephone_number": "708-386-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VA JESSE BROWN MEDICAL CENTER, 820 S. DAMEN AVE.",
            "address_2": "10514",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-569-6943",
            "fax_number": "312-569-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNAIRD",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.