Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kevin M Polky, LCSW

Individual provider Clinical Social Worker · NPI 1902094469

Mr. Kevin M Polky, LCSW is a Clinical Social Worker in Rockford, Illinois. Qualified in 1995, 31 years ago. Practices with Four Corners Wellness Center, Ltd, a 7-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
31
Licensed in
IL
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

461 N Mulford Rd Condo #1
Rockford, IL 61107-5190
Phone: (815) 395-1141
Fax: (815) 395-1117
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (IL)

Record details

NPI number1902094469
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedOctober 10, 2007
Last updated in NPPESOctober 10, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Four Corners Wellness Center, Ltd — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rockford