Individual provider Active NPI

Denise Kitanovski

  • Professional Counselor
  • Northfield, IL
National Provider Identifier
1225457153
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010855 Issued in IL
Practice address
400 Central Ave Ste 250
Northfield, IL 60093-3024
Phone
(847) 739-3000
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180010855 IL Primary

Addresses

Primary practice location

400 Central Ave Ste 250
Northfield, IL 60093-3024

Mailing address

400 Central Ave Ste 250
Northfield, IL 60093-3024
Phone (847) 739-3000

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 10, 2024 through Jan 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180010855ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life in Harmony Counseling PLLC Professional Current Accepting new patients
Samaritan Counseling Center PastSince Jul 24, 2022 Accepting new patients

Locations

400 Central Ave
Ste 250
Northfield, IL 60093
Phone (847) 350-8277

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.

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1225457153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE STE 250",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933024",
            "telephone_number": "847-739-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE STE 250",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933024",
            "telephone_number": "847-739-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITANOVSKI",
        "first_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

Verify at the official NPI Registry.