Active NPI
Gina Wickersheim
- Professional Counselor
- Chicago, IL
National Provider Identifier
1073168928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 401 W Ontario St Ste 200
Chicago, IL 60654-6957 - Phone
- (920) 277-5493
- NPI assigned
- Aug 7, 2019
- 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 | Primary |
Addresses
Primary practice location
401 W Ontario St Ste 200
Chicago, IL 60654-6957
Mailing address
3317 N Claremont Ave
Chicago, IL 60618-6205
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1073168928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3317 N CLAREMONT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606186205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W ONTARIO ST STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606546957",
"telephone_number": "920-277-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKERSHEIM",
"first_name": "GINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
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- Wicker Park Renaissance
- Wicker Park Spine and Stability, LLC
- Wicker Park Therapy Group, PLLC
- Wickery Speech and Language Services
- Julie Wickery, M.A. CCC-SLP
- Jillian Marie Wickham, PA-C
- John B Wickham
- Kelly Hameline Wicklander, RD, LDN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.