Agnieszka Alina Wysocka

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180005556 Issued in IL

Practice address

4419 W North Ave
Melrose Park, IL 60160-1021

Phone

(773) 777-7112

Fax

(708) 547-7732

NPI assigned

Dec 9, 2015

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

Practice roles

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.

• Youth Outreach Services

  • Community/Behavioral Health Agency
  • Melrose Park, IL
  • NPI 1568916476
  NPD (past)
• Youth Outreach Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Melrose Park, IL
  • NPI 1811227341
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1043685589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 HASSELL RD",
            "address_2": "APT #201",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601696340",
            "telephone_number": "847-922-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601021",
            "telephone_number": "773-777-7112",
            "fax_number": "708-547-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKA",
        "first_name": "AGNIESZKA",
        "middle_name": "ALINA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Women'S Healthcare Partners, S.C.
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• Lawrence Woznicki, MS,CADC
• WSKC Dialysis Services, Inc.
• Pingchun Wu, MA
• Vijay Yeldandi, MD
• Mary C Yerkes, RPH
• Angela Young, HS
• Your Doc of Melrose Park
• Youth Outreach Services

• All providers in Melrose Park, IL
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.