Active NPI
Karen M Wydra, MA
- Counselor
- Naperville SE, IL
National Provider Identifier
1275609703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1001 E Chicago Ave
Suite 151
Naperville SE, IL 60540 - Phone
- (630) 305-4196
- Fax
- (630) 305-4785
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | IL | Primary |
Addresses
Primary practice location
1001 E Chicago Ave
Suite 151
Naperville SE, IL 60540
Mailing address
1001 E Chicago Ave
Suite 151
Naperville SE, IL 60540
Phone (630) 305-4196
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180004261 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Friends | Counselor | Past | Accepting new patients |
| Little Friends Center for Autism, Inc. | 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.
-
- Community/Behavioral Health Agency
- Naperville, IL
- NPI 1194959767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275609703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 E CHICAGO AVE",
"address_2": "SUITE 151",
"city": "NAPERVILLE SE",
"state": "IL",
"postal_code": "60540",
"telephone_number": "630-305-4196",
"fax_number": "630-305-4785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E CHICAGO AVE",
"address_2": "SUITE 151",
"city": "NAPERVILLE SE",
"state": "IL",
"postal_code": "60540",
"telephone_number": "630-305-4196",
"fax_number": "630-305-4785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYDRA",
"first_name": "KAREN",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.