Miss Kimberley B Herzog, LISW-S is a medicare enrolled "Social Worker - Clinical" provider in Peoria, Illinois. She went to Washington University School Of Medicine and graduated in 2005 and has 21 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Osf Multi-specialty Group and her current practice location is
5111 N Glen Park Place Rd, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 683-5700.
Miss Kimberley B Herzog is licensed to practice in Illinois (license number 149021356) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1134585441.
Healthcare Provider's Profile
| Full Name | Miss Kimberley B Herzog |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 21 Years |
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| Location | 5111 N Glen Park Place Rd, Peoria, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Miss Kimberley B Herzog attended and graduated from Washington University School Of Medicine in 2005
NPI Data:
- NPI Number: 1134585441
- Provider Enumeration Date: 01/04/2016
- Last Update Date: 08/12/2019
Medicare PECOS Information:
- PECOS PAC ID: 4082917125
- Enrollment ID: I20190903000137
Medical Identifiers
Medical identifiers for Miss Kimberley B Herzog such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1134585441 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | I1501458S (Ohio) | Secondary |
| 104100000X | Social Worker | 149021356 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149021356 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Osf Multi-specialty Group | 3678889789 | 1848 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Miss Kimberley B Herzog allows following entities to bill medicare on her behalf.
| Entity Name | Osf Multi-specialty Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922445527
PECOS PAC ID: 3678889789
Enrollment ID: O20150904000279 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Kimberley B Herzog is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Miss Kimberley B Herzog, LISW-S
5111 N Glen Park Place Rd,
Peoria, IL 61614-4675
Ph: (309) 683-5700 | Miss Kimberley B Herzog, LISW-S
5111 N Glen Park Place Rd,
Peoria, IL 61614-4675
Ph: (309) 683-5700 |
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