Active NPI
Mark Woodward, MS, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1194835959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-002973
- Practice address
- 77 E. Washington St.
Suite 1925
Chicago, IL 60602 - Phone
- (312) 343-2424
- Fax
- (773) 944-0233
- NPI assigned
- Aug 30, 2006
- 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 | 180-002973 | IL | Primary |
Addresses
Primary practice location
77 E. Washington St.
Suite 1925
Chicago, IL 60602
Mailing address
5455 N Sheridan Rd
#2211
Chicago, IL 60640-1958
Phone (312) 343-2424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-002973 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1194835959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5455 N SHERIDAN RD",
"address_2": "#2211",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401958",
"telephone_number": "312-343-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 E. WASHINGTON ST.",
"address_2": "SUITE 1925",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60602",
"telephone_number": "312-343-2424",
"fax_number": "773-944-0233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODWARD",
"first_name": "MARK",
"credential": "MS, LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-002973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.