Provider Demographics
NPI:1891034542
Name:KIMPTON, KARI LG (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:LG
Last Name:KIMPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KARI
Other - Middle Name:L
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1701 E WOODFIELD ROAD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5113
Mailing Address - Country:US
Mailing Address - Phone:847-240-2211
Mailing Address - Fax:847-240-2418
Practice Address - Street 1:3 W HAWTHORN PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1447
Practice Address - Country:US
Practice Address - Phone:847-932-0808
Practice Address - Fax:847-918-8215
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0110331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1633897OtherBCBS GROUP NUMBER