Active NPI
Michelle Decola
- Professional Counselor
- Chicago, IL
National Provider Identifier
1386809580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180002541
- Practice address
- 875 N Dearborn St Ste 204
Chicago, IL 60610-3397 - Phone
- (312) 458-0646
- NPI assigned
- Jul 28, 2008
- 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 | 180002541 | IL | Primary |
Addresses
Primary practice location
875 N Dearborn St Ste 204
Chicago, IL 60610-3397
Mailing address
638 N Euclid Ave
Oak Park, IL 60302-1620
Phone (773) 497-7090
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 |
|---|---|---|---|
| 180002541 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1386809580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "638 N EUCLID AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603021620",
"telephone_number": "773-497-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 N DEARBORN ST STE 204",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606103397",
"telephone_number": "312-458-0646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECOLA",
"first_name": "MICHELLE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-28",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180002541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.