Individual provider Active NPI

Christian Ledezma

  • Mental Health Counselor
  • Oak Brook, IL
National Provider Identifier
1235644980
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1100 Jorie Blvd Ste 300
Oak Brook, IL 60523-2219
Phone
(630) 974-6602
Fax
(630) 487-2411
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1100 Jorie Blvd Ste 300
Oak Brook, IL 60523-2219

Mailing address

917 Oakwood Dr
Round Lake Beach, IL 60073-1504
Phone (224) 308-8373

Other practice location 1

3010 Grand Ave
Waukegan, IL 60085-2321
Phone (847) 377-8000

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
I20251028003675 IL Practitioner - Mental Health Counselor 1850880022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Vanderbilt University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1100 Jorie Blvd
Suite 300
Oak Brook, IL 60523-3005

917 Oakwood Dr
Round Lake Beach, IL 60073-1504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Clinical Services PLLC CurrentSince Sep 18, 2025 Accepting new patients

Locations

3264 N Clark St
Chicago, IL 60657

815 W Van Buren St
Ste 302
Chicago, IL 60607

1100 Jorie Blvd
Ste 300
Oak Brook, IL 60523
Phone (224) 900-7867

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1235644980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 OAKWOOD DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731504",
            "telephone_number": "224-308-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JORIE BLVD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232219",
            "telephone_number": "630-974-6602",
            "fax_number": "630-487-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3010 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600852321",
            "country_code": "US",
            "telephone_number": "847-377-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDEZMA",
        "first_name": "CHRISTIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.