Active NPI
Debra Elizabeth Koenitz, LCPC, ATR-BC
- Professional Counselor
- Northbrook, IL
National Provider Identifier
1144350497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 3000 Dundee Rd
Suite 411-412
Northbrook, IL 60062-2422 - Phone
- (847) 525-6699
- NPI assigned
- Mar 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
3000 Dundee Rd
Suite 411-412
Northbrook, IL 60062-2422
Mailing address
209 Burchell Ave
Highwood, IL 60040-1201
Phone (847) 525-6699
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240506003666 | IL | Practitioner - Mental Health Counselor | 1557701687 | Practice locations: Beach Park, IL; Highwood, IL; Lake Villa, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
428 Green Bay Rd
Highwood, IL 60040-1306
Phone (847) 525-6699
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180003327 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144350497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 BURCHELL AVE",
"city": "HIGHWOOD",
"state": "IL",
"postal_code": "600401201",
"telephone_number": "847-525-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD",
"address_2": "SUITE 411-412",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622422",
"telephone_number": "847-525-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENITZ",
"first_name": "DEBRA",
"middle_name": "ELIZABETH",
"credential": "LCPC, ATR-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.