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NPI Code Detail

MEDICARE: ARIANA RENEE KILGORE LSW

MEDICARE:   ARIANA RENEE KILGORE  LSW
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 Worker150.114307IL

General Provider Information

NPI Number : 1174371819
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIANA RENEE KILGORE LSW
Provider Business Mailing Address
First Line : 5254 N ROCKWELL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5254 N ROCKWELL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3322
Country : US
Telephone Number : 218-260-7963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2024
Last Update Date : 01/13/2026

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Directions to “ ARIANA RENEE KILGORE LSW” Practice Location

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