Alex Ayala – Counselor in Wheeling, IL

Key facts

NPI: 1154912285
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
Practice address: 210 N Wolf Rd
Wheeling, IL 60090-2922
Phone: (847) 353-1500
NPI assigned: Feb 1, 2021
Sex: Male
Sole proprietor: No

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.

Omni Youth Services Mental Health Clinic/Center (Including Community Mental Health Center) · Wheeling, IL · NPI 1134369663

NPD (past)
Omni Youth Services Substance Use Disorder Rehabilitation Clinic/Center · Wheeling, IL · NPI 1720525678

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Omni Youth Services		Past since Feb 7, 2021	Accepting new patients
Omni Youth Services		Past since Feb 7, 2021	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X			Yes

Addresses

Primary practice location

210 N Wolf Rd
Wheeling, IL 60090-2922

Mailing address

1111 W Lake Cook Rd
Buffalo Grove, IL 60089-1926
Phone (847) 353-1758

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2021.

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1154912285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W LAKE COOK RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891926",
            "telephone_number": "847-353-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600902922",
            "telephone_number": "847-353-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

All providers in Wheeling, IL · Counselor in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.