Individual provider Active NPI

Nicole Patterson

  • Marriage & Family Therapist
  • Algonquin, IL
National Provider Identifier
1265203350
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001696 Issued in IL
Practice address
2100 Huntington Dr N Ste B
Algonquin, IL 60102-5940
Phone
(777) 779-7335
NPI assigned
Jan 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.001696 IL Primary

Addresses

Primary practice location

2100 Huntington Dr N Ste B
Algonquin, IL 60102-5940

Mailing address

PO Box 276
Sycamore, IL 60178-0276
Phone (779) 777-7335

Other practice location 1

1625 Bethany Rd
Sycamore, IL 60178-3124
Phone (779) 777-7335

Other practice location 2

2726 N Buffalo Grove Rd Apt 205
Arlington Heights, IL 60004-7304
Phone (779) 777-7335

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
I20240308000388 IL Practitioner - Marriage and Family Therapist 9133565591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Juniper Center PCGroup PAC ID 1557557725, 26 clinicians

Practice addresses (Care Compare)

1440 Renaissance Dr
Suite 320
Park Ridge, IL 60068-1471
Phone (847) 778-4533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
166.001696ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Birds Mental Health Services PLLC Past Accepting new patients

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": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1265203350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601780276",
            "telephone_number": "779-777-7335",
            "fax_number": "815-758-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HUNTINGTON DR N STE B",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025940",
            "telephone_number": "777-779-7335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Bethany Rd",
            "address_purpose": "LOCATION",
            "city": "Sycamore",
            "state": "IL",
            "postal_code": "601783124",
            "country_code": "US",
            "telephone_number": "779-777-7335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2726 N Buffalo Grove Rd Apt 205",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600047304",
            "country_code": "US",
            "telephone_number": "779-777-7335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.