Provider Demographics
NPI:1912525593
Name:WALGREN, KAILEE J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAILEE
Middle Name:J
Last Name:WALGREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KAILEE
Other - Middle Name:J
Other - Last Name:MARKETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:215 S MARGUERITE ST
Mailing Address - Street 2:
Mailing Address - City:COAL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60416-1424
Mailing Address - Country:US
Mailing Address - Phone:815-953-1985
Mailing Address - Fax:
Practice Address - Street 1:215 S MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1424
Practice Address - Country:US
Practice Address - Phone:815-953-1985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0220811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical