Nicole Perry

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178009414 Issued in IL

Practice address

624 W Roosevelt Rd
Wheaton, IL 60187-5060

Phone

(708) 232-0258

NPI assigned

Feb 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 515 Fitness Inc.

  • Professional Counselor
  • Wheaton, IL
  • NPI 1134508310
  Medicare reassignment NPD Authorized official
• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161
  NPD (past)

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1083006563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 WARRENVILLE RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896368",
            "telephone_number": "440-667-6195",
            "fax_number": "779-234-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875060",
            "telephone_number": "708-232-0258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Coal City",
            "state": "IL",
            "postal_code": "604161688",
            "country_code": "US",
            "telephone_number": "630-352-7267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 E Division St",
            "address_purpose": "LOCATION",
            "city": "Coal City",
            "state": "IL",
            "postal_code": "604163007",
            "country_code": "US",
            "telephone_number": "312-252-2074",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 E Geneva Rd",
            "address_purpose": "LOCATION",
            "city": "Carol Stream",
            "state": "IL",
            "postal_code": "601882457",
            "country_code": "US",
            "telephone_number": "815-469-1500",
            "fax_number": "630-326-7992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178009414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Perez
• Mari Flor Perez
• Nora Perez
• Daneille Marie Perri
• Kayla Perry
• Personalized Physicians Group LTD
• Dana M Peters, RD, LD
• Rilea Joy Petersen, LPC
• Colette L Petit, RN
• Casey Frances Petterson, MS, RN

• Professional Counselor in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.