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NPI Code Detail

MEDICARE: KIMBERLY C FOSTER LCSW

MEDICARE: KIMBERLY C FOSTER 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 Worker149021674IL
2104100000XSocial Worker150.101836IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1149021674OTHERILLCSW LICENSE

General Provider Information

NPI Number : 1841730074
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY C FOSTER LCSW
Provider Business Mailing Address
First Line : 725 SCHOOL ST STE A
Second Line :
City : MORRIS
State : IL
Zip : 60450-1207
Country : US
Telephone Number : 815-941-9124
Fax Number : 815-941-4363
Provider Business Practice Location Address
First Line : 1300 DRESDEN DR
Second Line :
City : MORRIS
State : IL
Zip : 60450-2476
Country : US
Telephone Number : 815-942-5200
Fax Number : 815-942-5330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2017
Last Update Date : 11/07/2019

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Directions to “ KIMBERLY C FOSTER LCSW” Practice Location

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