Individual provider Active NPI

Rebecca Van Loan, LCPC

  • Professional Counselor
  • Lisle, IL
National Provider Identifier
1053968750
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180014899 Issued in IL
Practice address
2525 Cabot Dr Ste 201
Lisle, IL 60532-3628
Phone
(847) 485-9265
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180014899 IL Primary

Addresses

Primary practice location

2525 Cabot Dr Ste 201
Lisle, IL 60532-3628

Mailing address

2525 Cabot Dr Ste 201
Lisle, IL 60532-3628
Phone (847) 485-9265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 28, 2024 through Aug 28, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180014899ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1053968750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CABOT DR STE 201",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323628",
            "telephone_number": "847-485-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CABOT DR STE 201",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323628",
            "telephone_number": "847-485-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LOAN",
        "first_name": "REBECCA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180014899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.