Individual provider Active NPI

Myra Felita Dillard

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1134876931
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
D46354677654 Issued in IL
Practice address
656 N Pine Ave
Chicago, IL 60644-1544
Phone
(773) 683-7489
NPI assigned
Mar 2, 2022
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 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 D46354677654 IL Primary

Addresses

Primary practice location

656 N Pine Ave
Chicago, IL 60644-1544

Mailing address

656 N Pine Ave
Chicago, IL 60644-1544
Phone (773) 683-7489

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
D46354677654ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1134876931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 N PINE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441544",
            "telephone_number": "773-683-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 N PINE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441544",
            "telephone_number": "773-683-7489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "MYRA",
        "middle_name": "FELITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "D46354677654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.