Michael N Wilson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.006114 Issued in IL

Practice address

1340 S Damen Ave
Chicago, IL 60608-1169

Phone

(312) 738-5926

Fax

(312) 666-6978

NPI assigned

Nov 12, 2009

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwest Family and Community Resources PC

  • Community/Behavioral Health Agency
  • Hazel Crest, IL
  • NPI 1770818064
  Medicare reassignment NPD

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1003143967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "312-738-5926",
            "fax_number": "312-666-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "312-738-5926",
            "fax_number": "312-666-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Wilson, O.T.
• Megan Erika Wilson, DNP
• Melody Wilson
• Michael C. Wilson
• Michael John Wilson, PH.D.
• Michelle Marie Wilson, OTR/L
• Nakii Valeeta Wilson, OTR
• Nicholas Wilson
• Nichole K Wilson
• Nicole Q Wilson, A.P.N,

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.