Active NPI
Melissa Kistner
- Professional Counselor
- Wheaton, IL
National Provider Identifier
1245362995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180004553
- Practice address
- 7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2037 - Phone
- (630) 653-2300
- Fax
- (630) 469-1363
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- 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 | 180004553 | IL | Primary |
Addresses
Primary practice location
7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2037
Mailing address
97 N Ott Ave
Glen Ellyn, IL 60137-5633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022-15643 | Other | IL | BLUE CROSS/BLUE SHIELD |
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 |
|---|---|---|---|
| 180004553 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Clinical Associates SC | Professional | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1245362995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 N OTT AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 BLANCHARD CIR",
"address_2": "SUITE 201",
"city": "WHEATON",
"state": "IL",
"postal_code": "601892037",
"telephone_number": "630-653-2300",
"fax_number": "630-469-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISTNER",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180004553",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "022-15643",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.