Healthcare Provider Details

I. General information

NPI: 1710881081
Provider Name (Legal Business Name): KREPAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6085 STRATHMOOR DR
ROCKFORD IL
61107-6635
US

IV. Provider business mailing address

2014 23RD ST
ROCKFORD IL
61108-6013
US

V. Phone/Fax

Practice location:
  • Phone: 815-713-6982
  • Fax:
Mailing address:
  • Phone: 815-713-6982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CLARA B PASILLAS
Title or Position: THERAPIST
Credential: LCSW
Phone: 815-713-6982