Individual provider Active NPI

Christina R Cerk, M.A, LCPC

  • Professional Counselor
  • Libertyville, IL
National Provider Identifier
1063785947
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180001800 Issued in IL
Practice address
1580 S Milwaukee Ave Ste 420
Libertyville, IL 60048-3775
Phone
(888) 726-7170
NPI assigned
Feb 22, 2012
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 180001800 IL
Professional Counselor 101YP2500X 180001800 IL Primary

Addresses

Primary practice location

1580 S Milwaukee Ave Ste 420
Libertyville, IL 60048-3775

Mailing address

754 Waterview Dr
Round Lake Park, IL 60073-2782
Phone (847) 334-7977

Other practice location 1

3010 Grand Ave
Waukegan, IL 60085-2321
Phone (847) 377-8278

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801001893 IL Practitioner - Mental Health Counselor 4880131358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4753 N Broadway St
Suite 403
Chicago, IL 60640-7910
Phone (779) 368-0060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care Therapy Services of Illinois PC CurrentSince Mar 15, 2025 Accepting new patients
KP Counseling LTD CurrentSince Jul 1, 2024 Accepting new patients
Optum Behavioral Care Therapy Services of Illinois PC CurrentSince Mar 15, 2025 Accepting new patients

Locations

180 N Michigan Ave
Ste 410
Chicago, IL 60601
Phone (312) 399-1033

4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780

12151 Regency Pkwy
Ste 12189
Huntley, IL 60142
Phone (779) 368-0660

Interoperability endpoints

  • Direct secure messaging: christina.cerk.1@28621.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1063785947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 WATERVIEW DR",
            "city": "ROUND LAKE PARK",
            "state": "IL",
            "postal_code": "600732782",
            "telephone_number": "847-334-7977",
            "fax_number": "847-740-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 420",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483775",
            "telephone_number": "888-726-7170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600852321",
            "country_code": "US",
            "telephone_number": "847-377-8278",
            "fax_number": "847-360-7377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERK",
        "first_name": "CHRISTINA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "M.A, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180001800",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180001800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.