Individual provider Active NPI

Patrick Joseph Fallon

  • Counselor
  • Wheaton, IL
National Provider Identifier
1285355040
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.014822 Issued in IL
Practice address
2100 Manchester Rd Ste 1510
Wheaton, IL 60187-4561
Phone
(630) 653-1717
Fax
(630) 653-7926
NPI assigned
Sep 8, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.014822 IL Primary

Addresses

Primary practice location

2100 Manchester Rd Ste 1510
Wheaton, IL 60187-4561

Mailing address

202 S Williston St
Wheaton, IL 60187-5914
Phone (630) 903-9535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20240612003264 IL Practitioner - Mental Health Counselor 0345782769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.014822ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Meier Clinics of Illinois, P.C. CurrentSince Apr 30, 2024 Accepting new patients
Meier Clinics of Illinois, P.C. CurrentSince Apr 30, 2024 Accepting new patients
Meier Clinics of Illinois, P.C. Current Accepting new patients

Locations

2100 Manchester Rd
Ste 1510
Wheaton, IL 60187
Phone (708) 653-1717

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1285355040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S WILLISTON ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875914",
            "telephone_number": "630-903-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD STE 1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874561",
            "telephone_number": "630-653-1717",
            "fax_number": "630-653-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.014822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.