Active NPI
Emily Bozic
- Professional Counselor
- Crystal Lake, IL
National Provider Identifier
1295253250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180013918
- Practice address
- 8600 U.S. RT. 14
Suite 110
Crystal Lake, IL 60012 - Phone
- (847) 721-5818
- NPI assigned
- Aug 30, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | 180013918 | IL | Primary |
Addresses
Primary practice location
8600 U.S. RT. 14
Suite 110
Crystal Lake, IL 60012
Mailing address
1410 Grandview CT
Algonquin, IL 60102-1995
Phone (847) 721-5818
Other practice location 1
5342 W Elm St
McHenry, IL 60050-4029
Phone (847) 931-2341 ext. 2355
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180013918 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Association for Individual Development | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Aurora, IL
- NPI 1821151119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633305600000",
"number": "1295253250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 GRANDVIEW CT",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601021995",
"telephone_number": "847-721-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 U.S. RT. 14",
"address_2": "SUITE 110",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60012",
"telephone_number": "847-721-5818"
}
],
"practiceLocations": [
{
"address_1": "5342 W Elm St",
"address_purpose": "LOCATION",
"city": "McHenry",
"state": "IL",
"postal_code": "600504029",
"country_code": "US",
"telephone_number": "847-931-2341 x2355",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOZIC",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-30",
"last_updated": "2021-10-04",
"certification_date": "2021-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180013918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.