Individual provider Active NPI

Karen Vachulcik, LCPC, NCC, CADC, BCC

  • Counselor
  • Homer Glen, IL
National Provider Identifier
1265869986
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180008797 Issued in IL
Practice address
13235 W Hiawatha Dr
Homer Glen, IL 60491-8637
Phone
(847) 927-2441
NPI assigned
Sep 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180008797 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30730 IL

Addresses

Primary practice location

13235 W Hiawatha Dr
Homer Glen, IL 60491-8637

Mailing address

13235 Hiawatha Drive
Homer Glen, IL 60491-8637

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

LicenseStateTypeSpecialty
180008797ILMDCounselor
30730ILMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Synergy, LLC Addiction (Substance Use Disorder) Past Accepting new patients
KMC Enterprises, Inc. Counselor 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": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1265869986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 HIAWATHA DRIVE",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 W HIAWATHA DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918637",
            "telephone_number": "847-927-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHULCIK",
        "first_name": "KAREN",
        "credential": "LCPC, NCC, CADC, BCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180008797",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.