Individual provider Active NPI

Jennifer Allen

  • Mental Health Counselor
  • Lincolnshire, IL
National Provider Identifier
1104533355
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178009821 Issued in IL
Practice address
175 Olde Half Day Rd Ste 140-9
Lincolnshire, IL 60069-3062
Phone
(847) 790-4959
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178009821 IL Primary

Addresses

Primary practice location

175 Olde Half Day Rd Ste 140-9
Lincolnshire, IL 60069-3062

Mailing address

60 W Terra Cotta Ave
Suite B #243
Crystal Lake, IL 60014

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

LicenseStateTypeSpecialty
178009821ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nikkie Evans, PLLC CurrentSince Oct 30, 2022 Accepting new patients

Locations

175 Olde Half Day Rd
Ste 140-9
Lincolnshire, IL 60069
Phone (847) 456-1880

5 Revere Dr
Ste 200
Northbrook, IL 60062
Phone (630) 291-3206

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.

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1104533355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W TERRA COTTA AVE",
            "address_2": "SUITE B #243",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 OLDE HALF DAY RD STE 140-9",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693062",
            "telephone_number": "847-790-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178009821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnshire, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.