Individual provider Active NPI

Katherina Krentkowski, LCPC, LMHC

  • Mental Health Counselor
  • Oak Brook, IL
National Provider Identifier
1285793463
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001657A Issued in IN
Practice address
3500 Spring Rd
Oak Brook, IL 60523-2718
Phone
(630) 655-0404
Fax
(630) 655-0101
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001657A IN Primary
Mental Health Counselor 101YM0800X 180.006784 IL

Addresses

Primary practice location

3500 Spring Rd
Oak Brook, IL 60523-2718

Mailing address

3500 Spring Rd
Oak Brook, IL 60523-2718
Phone (630) 655-0404

Other practice location 1

962 W US Highway 30 Unit 8
Schererville, IN 46375-1551
Phone (708) 845-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231207003271 IN Practitioner - Mental Health Counselor 0749639359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Christian Counseling Center IncGroup PAC ID 1052395258, 20 clinicians

Practice addresses (Care Compare)

962 W US Hwy 30
Unit 8
Schererville, IN 46375-1551
Phone (708) 845-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.006784ILMDMental Health Counselor
39001657AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Christian Counseling Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Frances Gaik PC Past Accepting new patients
Donald J. Olund P.C. Past Accepting new patients

Locations

15127 S 73rd Ave
Ste G
Orland Park, IL 60462
Phone (630) 990-1935

962 W US Highway 30
Unit 8
Schererville, IN 46375
Phone (219) 864-4363

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1285793463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 SPRING RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232718",
            "telephone_number": "630-655-0404",
            "fax_number": "630-655-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SPRING RD",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232718",
            "telephone_number": "630-655-0404",
            "fax_number": "630-655-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "962 W US Highway 30 Unit 8",
            "address_purpose": "LOCATION",
            "city": "Schererville",
            "state": "IN",
            "postal_code": "463751551",
            "country_code": "US",
            "telephone_number": "708-845-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRENTKOWSKI",
        "first_name": "KATHERINA",
        "credential": "LCPC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001657A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006784",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.