Individual provider Active NPI

Kyla Shaneek O'Neal, LCPC

  • Professional Counselor
  • Homewood, IL
National Provider Identifier
1114431764
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180011202 Issued in IL
Practice address
935 175TH St Ste 300
Homewood, IL 60430
Phone
(414) 885-5193
NPI assigned
Nov 17, 2017
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 122770 IA
Professional Counselor 101YP2500X 22676 AZ
Professional Counselor 101YP2500X 180011202 IL Primary

Addresses

Primary practice location

935 175TH St Ste 300
Homewood, IL 60430

Mailing address

22923 Valley Dr
Richton Park, IL 60471-2338
Phone (708) 639-0763

Other practice location 1

405 W 35th St Apt 304
Steger, IL 60475-1475
Phone (708) 639-0763

Other practice location 2

699 Walnut St Ste 4004th
Des Moines, IA 50309-3929
Phone (415) 424-4266

Other practice location 3

111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Phone (415) 424-4266

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
I20251006003737 IL Practitioner - Mental Health Counselor 9032616271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1220 S Wood St
Chicago, IL 60608-1202

22923 Valley Dr
Richton Park, IL 60471-2338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22676AZMDProfessional Counselor
122770IAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Sep 24, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 24, 2025 Accepting new patients

Locations

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

7702 Solution Ctr
Chicago, IL 60677

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1114431764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22923 VALLEY DR",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604712338",
            "telephone_number": "708-639-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 175TH ST STE 300",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "60430",
            "telephone_number": "414-885-5193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W 35th St Apt 304",
            "address_purpose": "LOCATION",
            "city": "Steger",
            "state": "IL",
            "postal_code": "604751475",
            "country_code": "US",
            "telephone_number": "708-639-0763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "699 Walnut St Ste 4004th",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503093929",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 W Jackson Blvd Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606043597",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "KYLA",
        "middle_name": "SHANEEK",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IA",
            "license": "122770",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "22676",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.