Deva Suckerman, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180004444 Issued in IL

Practice address

140 Harrison St
#Ge
Oak Park, IL 60304-1600

Phone

(312) 399-7143

Fax

(312) 492-9058

NPI assigned

Jan 29, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1003093261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 W BLOOMINGDALE AVE APT 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474366",
            "telephone_number": "312-399-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HARRISON ST",
            "address_2": "#GE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041600",
            "telephone_number": "312-399-7143",
            "fax_number": "312-492-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKERMAN",
        "first_name": "DEVA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180004444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.