Individual provider Active NPI

Kris Kirilova, LCPC

  • Professional Counselor
  • Evanston, IL
National Provider Identifier
1124410147
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.010767 Issued in IL
Practice address
990 Grove St Ste 405
Evanston, IL 60201-4370
Phone
(888) 726-7170
NPI assigned
Feb 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.011276 IL
Professional Counselor 101YP2500X 178.010767 IL Primary

Addresses

Primary practice location

990 Grove St Ste 405
Evanston, IL 60201-4370

Mailing address

990 Grove St Ste 405
Evanston, IL 60201-4370
Phone (888) 726-7170

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
178.010767ILMDProfessional Counselor
180.011276ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1124410147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 GROVE ST STE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014370",
            "telephone_number": "888-726-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GROVE ST STE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014370",
            "telephone_number": "888-726-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRILOVA",
        "first_name": "KRIS",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011276",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.010767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.