Active NPI
Kelleen M Urbon
- Professional Counselor
- Yorkville, IL
National Provider Identifier
1073514774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-000218
- Practice address
- 110 E Countryside Pkwy
Yorkville, IL 60560-1813 - Phone
- (630) 553-1600
- Fax
- (630) 553-7993
- NPI assigned
- Aug 3, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 180-000218 | IL | Primary |
Addresses
Primary practice location
110 E Countryside Pkwy
Yorkville, IL 60560-1813
Mailing address
1120 E Main St
Ste. 201
St Charles, IL 60174-2287
Phone (630) 377-6613
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180-000218 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centennial Counseling Center, PC | 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.
-
- Mental Health Counselor
- St Charles, IL
- NPI 1376544387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1073514774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 E MAIN ST",
"address_2": "STE. 201",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601742287",
"telephone_number": "630-377-6613",
"fax_number": "630-377-6225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E COUNTRYSIDE PKWY",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605601813",
"telephone_number": "630-553-1600",
"fax_number": "630-553-7993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URBON",
"first_name": "KELLEEN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-000218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorkville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.