Individual provider Active NPI

Eunsil Kim, LPC

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1083585343
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.022052 Issued in IL
Practice address
1819 Bay Scott Cir
Naperville, IL 60540-1129
Phone
(630) 357-2456
Fax
(630) 357-2482
NPI assigned
Sep 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 178.022052 IL Primary

Addresses

Primary practice location

1819 Bay Scott Cir
Naperville, IL 60540-1129

Mailing address

1652 Westminster Dr
Naperville, IL 60563-9208
Phone (630) 357-2456

Other practice location 1

1761 S Naperville Rd Ste 200
Wheaton, IL 60189-5846
Phone (630) 260-0606 ext. 149

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
I20251125001503 IL Practitioner - Mental Health Counselor 0648762005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1819 Bay Scott Cir
Naperville, IL 60540-1129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.022052ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Interfaith Counseling Center Inc. Single Specialty CurrentSince Oct 1, 2025 Accepting new patients
Samaritan Counseling Center Single Specialty PastSince Oct 1, 2025 Accepting new patients

Locations

1819 Bay Scott Cir
Ste 109
Naperville, IL 60540
Phone (630) 357-2456

1761 S Naperville Rd
Ste 200
Wheaton, IL 60189
Phone (630) 260-0606

Organizations & group practices 2

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": "1758067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1083585343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 WESTMINSTER DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639208",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401129",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1761 S Naperville Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601895846",
            "country_code": "US",
            "telephone_number": "630-260-0606 x149",
            "fax_number": "630-357-2482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUNSIL",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.022052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.