Individual provider Active NPI

Loretta Talyn Sumerset-Young

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1104397108
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
2611 S Indiana Ave Unit a
Chicago, IL 60616-2326
Phone
(708) 829-7939
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

2611 S Indiana Ave Unit a
Chicago, IL 60616-2326

Mailing address

2611 S Indiana Ave Unit a
Chicago, IL 60616-2326
Phone (708) 829-7939

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
I20240705001396 IL Practitioner - Mental Health Counselor 6204370984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Dec 17, 2025 Accepting new patients
Rush University Medical Center CurrentSince Apr 22, 2024 Accepting new patients
Rush University Medical Center CurrentSince Apr 22, 2024 Accepting new patients
Nupath to Wellness Current Accepting new patients

Locations

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1653 W Congress Pkwy
Ste 739
Chicago, IL 60612
Phone (312) 942-3134

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Organizations & group practices 4

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1104397108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 S INDIANA AVE UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162326",
            "telephone_number": "708-829-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 S INDIANA AVE UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162326",
            "telephone_number": "708-829-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMERSET-YOUNG",
        "first_name": "LORETTA",
        "middle_name": "TALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "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

Sources for this page

Verify at the official NPI Registry.