NPIMap

Organization Active NPI

Consuelo, Inc.

  • Clinic/Center
  • Waukegan, IL
National Provider Identifier
1407555477
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CONSUELO, INC.
Practice address
33 N County St
Waukegan, IL 60085-4315
Phone
(773) 581-4357
Fax
(773) 498-7186
NPI assigned
Feb 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Patricia Perez, LCSW, MBANPI 1972807493
Title
President/Ceo
Phone
(773) 581-4357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X
Clinic/Center 261Q00000X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

33 N County St
Waukegan, IL 60085-4315

Mailing address

6149 S Kenneth Ave # 2ND
Chicago, IL 60629-5209
Phone (773) 616-1095

Other names 1

  • Consuelo Therapeutic Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consuelo Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6149 S Kenneth Ave
Chicago, IL 60629
Phone (773) 258-1435

33 N County St
Waukegan, IL 60085
Phone (773) 581-4357

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1407555477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 S KENNETH AVE # 2ND",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295209",
            "telephone_number": "773-616-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N COUNTY ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854315",
            "telephone_number": "773-581-4357",
            "fax_number": "773-498-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSUELO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-581-4357",
        "authorized_official_credential": "LCSW, MBA"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consuelo Therapeutic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.