Healthcare Provider Details

I. General information

NPI: 1730666157
Provider Name (Legal Business Name): ELIZABETH KROENING MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date: 06/15/2020
Reactivation Date: 07/09/2026

III. Provider practice location address

6260 E RIVERSIDE BLVD # 104
LOVES PARK IL
61111-4418
US

IV. Provider business mailing address

6260 E RIVERSIDE BLVD # 104
LOVES PARK IL
61111-4418
US

V. Phone/Fax

Practice location:
  • Phone: 847-800-7941
  • Fax:
Mailing address:
  • Phone: 847-800-7941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.020507
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: