Healthcare Provider Details

I. General information

NPI: 1235846965
Provider Name (Legal Business Name): KATHERINE FEARON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N HICKS RD
PALATINE IL
60067-3614
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0190
  • Fax: 847-618-4171
Mailing address:
  • Phone: 847-982-3175
  • Fax: 847-982-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.024685
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: