Individual provider Active NPI

Michelle Robin Wichter

  • Addiction (Substance Use Disorder) Counselor
  • Mundelein, IL
National Provider Identifier
1154845923
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
34386 Issued in IL
Practice address
1606 Woodhaven CT.
Mundelein, IL 60060
Phone
(847) 668-9584
NPI assigned
Aug 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.012465 IL
Addiction (Substance Use Disorder) Counselor 101YA0400X 34386 IL Primary

Addresses

Primary practice location

1606 Woodhaven CT.
Mundelein, IL 60060

Mailing address

1606 Woodhaven CT
Mundelein, IL 60060-1539
Phone (847) 668-9584

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
34386ILMDAddiction (Substance Use Disorder) Counselor
178.012465ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154845923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 WOODHAVEN CT",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601539",
            "telephone_number": "847-668-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 WOODHAVEN CT.",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "60060",
            "telephone_number": "847-668-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHTER",
        "first_name": "MICHELLE",
        "middle_name": "ROBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.012465",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "34386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.