Individual provider Active NPI

Stephanie Willms Quattrocki, MA, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1205331386
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178913472. Issued in IL
Practice address
5500 W Devon Ave
Chicago, IL 60646-4021
Phone
(773) 763-3433
NPI assigned
Mar 29, 2018
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178013472 NU
Professional Counselor 101YP2500X 178013472 IL
Professional Counselor 101YP2500X 178913472. IL Primary

Addresses

Primary practice location

5500 W Devon Ave
Chicago, IL 60646-4021

Mailing address

5500 W Devon Ave
Chicago, IL 60646-4021
Phone (773) 763-3433

Other names 1

  • Mrs. Stephanie Lee Willms Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215003610 IL Practitioner - Mental Health Counselor 0749624989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Advanced Psychiatric Solutions, IncGroup PAC ID 9638535354, 25 clinicians

Practice addresses (Care Compare)

1200 Harger Rd
Suite 200
Oak Brook, IL 60523-1816
Phone (630) 607-0387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178013472ILMDProfessional Counselor
178913472.ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Solutions Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1721 Moon Lake Blvd
Ste 201
Hoffman Estates, IL 60169
Phone (630) 607-0387

1284 Rickert Dr
Ste 200
Naperville, IL 60540
Phone (630) 607-0387

1200 Harger Rd
Ste 200
Oak Brook, IL 60523
Phone (630) 556-8914

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.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1205331386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464021",
            "telephone_number": "773-763-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464021",
            "telephone_number": "773-763-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUATTROCKI",
        "first_name": "STEPHANIE",
        "middle_name": "WILLMS",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": "178013472",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178013472",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178913472.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WILLMS",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.