Kaileen Banaszak Gaumer

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.005831 Issued in IL

Practice address

629 N Galena Ave Ste 120
Dixon, IL 61021-1664

Phone

(815) 288-1235

NPI assigned

Apr 20, 2023

Last updated

Apr 20, 2023By the provider in NPPES

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment Care Compare group NPD
• Next Step Counseling, PLLC

  • Professional Counselor
  • Sterling, IL
  • NPI 1790625671
  NPD Authorized official

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1093402984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 CRESTVIEW RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610814314",
            "telephone_number": "630-781-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N GALENA AVE STE 120",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211664",
            "telephone_number": "815-288-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUMER",
        "first_name": "KAILEEN",
        "middle_name": "BANASZAK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.005831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reide Allen Gallaway, RBT
• Nathan Gallo, RBT
• Claudia Garcia Ibarra, RBT
• Genevieve Gassner
• Melissa A Gates, LCSW
• Matthew Michael Gecan, MSW
• Christina Marie Geiselhart, LCSW
• Patricia J Geisz, P.T.
• Genoa Healthcare LLC
• Shirley Jean Genz

• Professional Counselor in Dixon, IL
• Providers in Dixon, 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 20, 2023; 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.