Active NPI
Lidya Agustina Tandayu, MA
- Professional Counselor
- Elgin, IL
National Provider Identifier
1356136758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178019770
- Practice address
- 1595 Weld Rd Ste 9
Elgin, IL 60123-5896 - Phone
- (847) 707-2689
- NPI assigned
- Apr 14, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178019770 | IL | Primary |
Addresses
Primary practice location
1595 Weld Rd Ste 9
Elgin, IL 60123-5896
Mailing address
6800 W Raven St Unit 410
Chicago, IL 60631-2529
Phone (773) 695-9559
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178019770 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744588800000",
"number": "1356136758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 W RAVEN ST UNIT 410",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606312529",
"telephone_number": "773-695-9559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 WELD RD STE 9",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235896",
"telephone_number": "847-707-2689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANDAYU",
"first_name": "LIDYA",
"middle_name": "AGUSTINA",
"name_prefix": "Miss",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-14",
"last_updated": "2025-04-14",
"certification_date": "2025-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178019770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.