Individual provider Active NPI

Ann Marie Grossman

  • Professional Counselor
  • Bourbonnais, IL
National Provider Identifier
1013411693
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.018153 Issued in IL
Practice address
755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393
Phone
(630) 428-7890
Fax
(630) 428-7891
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.018153 IL Primary
Mental Health Counselor 101YM0800X 3365-226 WI

Addresses

Primary practice location

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393

Mailing address

755 Almar Pkwy Ste a
Bourbonnais, IL 60914-2393
Phone (630) 428-7890

Other practice location 1

6321 23rd Ave
Kenosha, WI 53143-4801
Phone (414) 455-3879 ext. 801

Other practice location 2

4001 W Capitol Dr
Milwaukee, WI 53216-2530
Phone (414) 455-3879 ext. 801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

755 Almar Pkwy
Suite a
Bourbonnais, IL 60914-2393

755 Almar Pkwy
Suite a
Bourbonnais, IL 60914-2512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3365-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Mental Health CurrentSince Jul 1, 2026 Accepting new patients
Amri Counseling Services, LLC PastSince Sep 10, 2018 Accepting new patients

Locations

755 Almar Pkwy
Ste A
Bourbonnais, IL 60914
Phone (815) 214-9079

755 Almar Pkwy
Bourbonnais, IL 60914
Phone (317) 366-9559

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1013411693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393",
            "telephone_number": "630-428-7890",
            "fax_number": "630-428-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 ALMAR PKWY STE A",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142393",
            "telephone_number": "630-428-7890",
            "fax_number": "630-428-7891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6321 23rd Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531434801",
            "country_code": "US",
            "telephone_number": "414-455-3879 x801",
            "fax_number": "866-719-3024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4001 W Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532162530",
            "country_code": "US",
            "telephone_number": "414-455-3879 x801",
            "fax_number": "866-719-3024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.018153",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3365-226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.