KP COUNSELING LTD – Clinical Social Worker, NPI 1770630766
Clinical Social Worker
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KP COUNSELING LTD
4753 N Broadway St Ste 403
Chicago, IL 606407910
Phone: (779) 368-0060
Type: Location
800 Main St Ste 210
Antioch, IL 600021578
Phone: (779) 368-0060
Type: Location
12151 Regency Pkwy Ste 12189
Huntley, IL 601427644
Phone: (779) 368-0060
Fax: (779) 368-0579
Type: Location
820 Davis St Ste 222
Evanston, IL 602014445
Phone: (779) 368-0060
Type: Location
180 N Michigan Ave Ste 410
Chicago, IL 606017488
Phone: (779) 368-0060
Type: Location
12151 Regency Pkwy Ste 12169
Huntley, IL 601427644
Phone: (815) 331-8768
Fax: (815) 331-8760
Type: Location
695 N Perryville Rd Ste 4
Rockford, IL 611076225
Phone: (779) 368-0060
Fax: (859) 977-4892
Type: Location
6392, Linden Road, Rockford, Winnebago County, Illinois, 61109, United States
ROCKFORD, IL 611092816
Phone: (779) 368-0060
Fax: (779) 368-0579
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (831 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040701000375 | O | Clinic/Group Practice | IL | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60640)
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