Courtney M Siewak, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

486 W Boughton Rd Ste B
Bolingbrook, IL 60440-2399

Phone

(630) 755-5278

NPI assigned

Feb 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rockford Psychiatric Medical Services, S.C.

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1821391442
  Medicare reassignment NPD

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1346947033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 SYMPHONY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045518",
            "telephone_number": "630-201-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 W BOUGHTON RD STE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402399",
            "telephone_number": "630-755-5278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEWAK",
        "first_name": "COURTNEY",
        "middle_name": "M",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shining Smiles LLC
• Milind Sham Shirsat, DO
• Anar K Shroff, D.P.T
• Tasin Shuaipaj, M.D.
• Zubair Siddiqui, D.C.
• Brittny E Silke, PT
• Raul J Silvera Hernandez, DMD
• Sim Transportaion
• Gigi Simmons, LCSW
• Jaslyn Madan Singh, LCPC,

• Professional Counselor in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.