Individual provider Active NPI

Lisa A Demarco, LCPC

  • Professional Counselor
  • Orland Park, IL
National Provider Identifier
1306994306
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
203070109 Issued in IL
Practice address
16660 S 107TH Ave
Orland Park, IL 60467
Phone
(815) 942-6323
Fax
(779) 210-5541
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 203070109 IL Primary

Addresses

Primary practice location

16660 S 107TH Ave
Orland Park, IL 60467

Mailing address

PO Box 713260
Chicago, IL 60677-0264
Phone (630) 469-9200

Other practice location 1

1239 Windham Pkwy
Romeoville, IL 60446-1608
Phone (815) 942-6323

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldemarco205900@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240212002869 IL Practitioner - Mental Health Counselor 7911340476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
203070109ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jan 2, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 2, 2024 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1239 Windham Pkwy
Romeoville, IL 60446

Interoperability endpoints

  • Direct secure messaging: ldemarco205900@dulyhealthandcare.direct-ci.com

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1306994306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770264",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16660 S 107TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60467",
            "telephone_number": "815-942-6323",
            "fax_number": "779-210-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1239 Windham Pkwy",
            "address_purpose": "LOCATION",
            "city": "Romeoville",
            "state": "IL",
            "postal_code": "604461608",
            "country_code": "US",
            "telephone_number": "815-942-6323",
            "fax_number": "779-210-5541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "203070109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldemarco205900@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16660 S 107th Ave",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.