Active NPI
Deborah E Sylvestrak, LCPC
- Professional Counselor
- South Holland, IL
National Provider Identifier
1154085389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.003662
- Practice address
- 15040 Wabash Ave
South Holland, IL 60473-1065 - Phone
- (708) 721-4476
- NPI assigned
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 180.003662 | IL | Primary |
Addresses
Primary practice location
15040 Wabash Ave
South Holland, IL 60473-1065
Mailing address
15040 Wabash Ave
South Holland, IL 60473-1065
Phone (708) 721-4476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180.003662 | Other | IL | LCPC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.003662 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1154085389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15040 WABASH AVE",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604731065",
"telephone_number": "708-721-4476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15040 WABASH AVE",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604731065",
"telephone_number": "708-721-4476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYLVESTRAK",
"first_name": "DEBORAH",
"middle_name": "E",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.003662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC",
"identifier": "180.003662",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Holland, IL
- Linda Marie Sutton, M.A. LCPC
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- Sweet Love Transportation Services
- Natalia Alina Szaflarski, D.O.
- Tamara & Raquel Home Healthcare Agency,L.L.C
- Teresa Denean Tarver, DOULA
- Nicole A Tefera, PSY.D.
- Theresa Teverbaugh, RN, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.