Mary J Jago Krueger, MS, LCPC, CGP
Individual provider Active NPI Professional Counselor · Cary, IL
NPI 1346333804 · NPPES record last updated Nov 4, 2008
Key facts
- NPI
- 1346333804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180-000191 (IL)
- Practice address
- 204 Spring Street #27
Cary, IL 60013 - Phone
- (847) 421-6152
- Fax
- (847) 639-4815
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 8, 2024 through Jun 8, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-000191 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-000191 | IL | Yes |
Addresses
Primary practice location
204 Spring Street #27
Cary, IL 60013
Mailing address
204 Spring St Ste 27
Cary, IL 60013-1475
Phone (847) 421-6152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180-000191 | Other | IL | LCPC |
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- Christine Anne Hughes
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- Anna M Iozzo
- James Massaro DPM, LTD
- Elizabeth Lynn Janczak
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- Rosemarie Denise Janowitz
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All providers in Cary, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.