The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Chicago and Illinois

2,406 active clinicians are listed under Counselor - Professional with a practice address in Chicago, IL (9,512 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Chicago

1.7% of these 2,406 clinicians have the CMS telehealth indicator.

5.5% of these 2,406 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-03-11

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES IL 178.021661

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.

Look Up on State Board Site

Career & Practice History

NPI enumerated March 11, 2026.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from April 2026 to August 2026.

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NPI Administrative Meta

NPI Number: 1699622589

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 11, 2026

Last Update: March 11, 2026

Sole Proprietor: No

Update or Correct Profile

Other Counselor - Professionals in Chicago

All Counselor - Professionals in Chicago

Mailing Address

1713 W 105th St

Chicago, IL 606432707

Phone: 7733205486

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.