Active NPI
Lisa Marie Van Dyke, LCPC
- Professional Counselor
- Plainfield, IL
National Provider Identifier
1356816581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180017204
- Practice address
- 24600 W 127TH St
Plainfield, IL 60585-9507 - Phone
- (815) 731-9100
- NPI assigned
- Oct 3, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180017204 | IL | Primary |
Addresses
Primary practice location
24600 W 127TH St
Plainfield, IL 60585-9507
Mailing address
2650 Ridge Ave # 1223
Evanston, IL 60201-1700
Other practice location 1
1717 N Naper Blvd Ste 109
Naperville, IL 60563-8837
Phone (847) 868-3435
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 |
|---|---|---|---|
| 180017204 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edgewood Clinical Services, P.C. | Mental Health | Current | Accepting new patients |
Locations
1717 N Naper Blvd
Ste 109
Naperville, IL 60563
900 E Diehl Rd
Ste 101
Naperville, IL 60563
Phone (630) 328-0134
175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125
Interoperability endpoints
- lifestancehealth.lisavandyke@146897.advancedmd-direct.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1356816581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE # 1223",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24600 W 127TH ST",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605859507",
"telephone_number": "815-731-9100"
}
],
"practiceLocations": [
{
"address_1": "1717 N Naper Blvd Ste 109",
"address_purpose": "LOCATION",
"city": "Naperville",
"state": "IL",
"postal_code": "605638837",
"country_code": "US",
"telephone_number": "847-868-3435",
"fax_number": "847-859-5885",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN DYKE",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-03",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180017204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plainfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.