Individual provider Active NPI

Evelyn Estrada

  • Professional Counselor
  • Berwyn, IL
National Provider Identifier
1396264354
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
6918 W Windsor Ave
Berwyn, IL 60402-3334
Phone
(708) 745-5277
NPI assigned
Sep 11, 2017
Last updated
Aug 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

6918 W Windsor Ave
Berwyn, IL 60402-3334

Mailing address

5220 East Ave
Countryside, IL 60525-3133
Phone (708) 745-5277

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240102001894 IL Practitioner - Mental Health Counselor 4880044932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Pillars Community HealthGroup PAC ID 9032367859, 7 clinicians

Practice addresses (Care Compare)

6918 W Windsor Ave
Berwyn, IL 60402-3334
Phone (708) 745-5277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pillars Community Health Mental Health Current Accepting new patients
Pillars Community Health CurrentSince Jan 1, 2024 Accepting new patients
Pillars Community Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

6918 W Windsor Ave
Berwyn, IL 60402
Phone (708) 795-4800

5220 East Ave
Countryside, IL 60525

8020 W 87th St
Hickory Hills, IL 60457
Phone (708) 741-4500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1396264354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 EAST AVE",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253133",
            "telephone_number": "708-745-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 W WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023334",
            "telephone_number": "708-745-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "EVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.