Individual provider Active NPI

Gloria O'Bannon

  • Mental Health Counselor
  • Geneva, IL
National Provider Identifier
1013726488
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1120 Randall CT
Geneva, IL 60134-3911
Phone
(630) 232-1070
Fax
(630) 232-1471
NPI assigned
Dec 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1120 Randall CT
Geneva, IL 60134-3911

Mailing address

1120 Randall CT
Geneva, IL 60134-3911
Phone (630) 232-1070

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1013726488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 RANDALL CT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343911",
            "telephone_number": "630-232-1070",
            "fax_number": "630-232-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 RANDALL CT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343911",
            "telephone_number": "630-232-1070",
            "fax_number": "630-232-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BANNON",
        "first_name": "GLORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.