Active NPI
Diane Lorraine Siri, LCPC
- Professional Counselor
- Wauconda, IL
National Provider Identifier
1033390836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006685
- Practice address
- 109 S Main St
Wauconda, IL 60084-1825 - Phone
- (847) 337-1667
- Fax
- (224) 795-8920
- NPI assigned
- Nov 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180006685 | IL | Primary |
Addresses
Primary practice location
109 S Main St
Wauconda, IL 60084-1825
Mailing address
109 S Main St
Wauconda, IL 60084-1825
Phone (847) 337-1667
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240913001614 | IL | Practitioner - Mental Health Counselor | 4981859204 | Practice locations: Wauconda, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
109 S Main St
Wauconda, IL 60084-1825
Phone (847) 337-1659
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180006685 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1033390836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 S MAIN ST",
"city": "WAUCONDA",
"state": "IL",
"postal_code": "600841825",
"telephone_number": "847-337-1667",
"fax_number": "224-795-8920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 S MAIN ST",
"city": "WAUCONDA",
"state": "IL",
"postal_code": "600841825",
"telephone_number": "847-337-1667",
"fax_number": "224-795-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRI",
"first_name": "DIANE",
"middle_name": "LORRAINE",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-20",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauconda, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.