Active NPI
Erick Alexeyev
- Professional Counselor
- Lake Villa, IL
National Provider Identifier
1174282727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006586
- Practice address
- 420 West Grand Avenue
Lake Villa, IL 60046 - Phone
- (847) 245-6156
- Fax
- (847) 356-2350
- NPI assigned
- Dec 10, 2021
- Last updated
- Dec 10, 2021
- Sex
- Male
- 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 | 180006586 | IL | Primary |
Addresses
Primary practice location
420 West Grand Avenue
Lake Villa, IL 60046
Mailing address
PO Box 1088
Lake Villa, IL 60046-1088
Phone (847) 245-6156
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 |
|---|---|---|---|
| 180006586 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allendale Association | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lake Villa, IL
- NPI 1821051608
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639094400000",
"number": "1174282727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1088",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600461088",
"telephone_number": "847-245-6156",
"fax_number": "847-356-2360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 WEST GRAND AVENUE",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "60046",
"telephone_number": "847-245-6156",
"fax_number": "847-356-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXEYEV",
"first_name": "ERICK",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-10",
"last_updated": "2021-12-10",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Villa, IL
- Elizabeth Aden-Buie, LCSW
- Taylor Adkins
- Adult & Pediatric Orthopedics, S.C.
- Advocate Health and Hospitals Corporation (Advocate Medical Group)
- Agape Chiropractic Center PC
- John Edwin Allen, RKT
- Richard Allen
- Allendale Association
- Allendale Association
- American Homecare LLC (Northern Rose Home Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.