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NPI Code Detail

MEDICARE: ALICIA KIMBALL LCSW

MEDICARE:   ALICIA  KIMBALL  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1063883957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA KIMBALL LCSW
Provider Business Mailing Address
First Line : 1901 N ROSELLE RD STE 800
Second Line :
City : SCHAUMBURG
State : IL
Zip : 60195-3186
Country : US
Telephone Number : 847-220-7603
Fax Number :
Provider Business Practice Location Address
First Line : 1901 N ROSELLE RD STE 800
Second Line :
City : SCHAUMBURG
State : IL
Zip : 60195-3186
Country : US
Telephone Number : 847-220-7603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2015
Last Update Date : 05/20/2021

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Directions to “ ALICIA KIMBALL LCSW” Practice Location

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