Individual provider Active NPI

Jessica Emelie Risker, LCPC

  • Counseling Psychologist
  • Libertyville, IL
National Provider Identifier
1154514115
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
178.004967 Issued in IL
Practice address
31480 N Highway 45
Libertyville, IL 60048
Phone
(847) 680-2715
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 180008062 IL
Counseling Psychologist 103TC1900X 178.004967 IL Primary

Addresses

Primary practice location

31480 N Highway 45
Libertyville, IL 60048

Mailing address

5476 W Higgins Ave Unit Ge
Chicago, IL 60630-2176
Phone (773) 316-8693

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
178.004967ILMDCounseling Psychologist
180008062ILMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunbeams Mental Wellness Counseling Current Accepting new patients
Sunbeams Mental Wellness LLC Current Accepting new patients

Locations

1286 N Milwaukee Ave
Ste 8
Chicago, IL 60622
Phone (206) 734-0266

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1154514115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5476 W HIGGINS AVE UNIT GE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302176",
            "telephone_number": "773-316-8693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31480 N HIGHWAY 45",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-680-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISKER",
        "first_name": "JESSICA",
        "middle_name": "EMELIE",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "180008062",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "178.004967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.