Active NPI
Kassandra A Patankar, LCPC
- Professional Counselor
- Round Lake, IL
National Provider Identifier
1255812202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180012913
- Practice address
- 451 W Waterbury Dr
Round Lake, IL 60073-5704 - Phone
- (847) 481-6742
- NPI assigned
- Aug 28, 2018
- 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 | 180012913 | IL | Primary |
Addresses
Primary practice location
451 W Waterbury Dr
Round Lake, IL 60073-5704
Mailing address
781 S Midlothian Rd # 154
Mundelein, IL 60060-2686
Phone (847) 481-6742
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 |
|---|---|---|---|
| 180012913 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768262400000",
"number": "1255812202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "781 S MIDLOTHIAN RD # 154",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600602686",
"telephone_number": "847-481-6742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 W WATERBURY DR",
"city": "ROUND LAKE",
"state": "IL",
"postal_code": "600735704",
"telephone_number": "847-481-6742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATANKAR",
"first_name": "KASSANDRA",
"middle_name": "A",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2026-01-13",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180012913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.