Individual provider Active NPI

Judith Lopez Albalawneh

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1073074118
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.0012210 Issued in IL
Practice address
6250 W North Ave
Chicago, IL 60639-3861
Phone
(773) 622-6218
Fax
(773) 622-7440
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180.0012210 IL Primary
Professional Counselor 101YP2500X 178013073 IL

Addresses

Primary practice location

6250 W North Ave
Chicago, IL 60639-3861

Mailing address

6727 W Irving Park Rd Apt 1B
Chicago, IL 60634-2335

Other practice location 1

1255 W 18th St
Chicago, IL 60608-3242
Phone (773) 622-6218

Other practice location 2

3166 N Lincoln Ave
Chicago, IL 60657-3133
Phone (773) 622-6218

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

State licenses

LicenseStateTypeSpecialty
178013073ILMDProfessional Counselor
180.0012210ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Castillo for Personal and Family Wellbeing, LLC Professional Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1073074118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6727 W IRVING PARK RD APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393861",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606083242",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3166 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573133",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ ALBALAWNEH",
        "first_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.0012210",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178013073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.