Active NPI
Angie Mendez, M.ED
- Professional Counselor
- Chicago, IL
National Provider Identifier
1417628231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.018054
- Practice address
- 4732 N Austin Ave Unit a
Chicago, IL 60630-3785 - Phone
- (773) 501-4288
- NPI assigned
- Sep 22, 2021
- 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 | 180.018054 | IL | Primary |
Addresses
Primary practice location
4732 N Austin Ave Unit a
Chicago, IL 60630-3785
Mailing address
1209 N Leclaire Ave Apt 3N
Chicago, IL 60651-1545
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.018054 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Youth Services | Past | Accepting new patients | |
| Omni Youth Services | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Wheeling, IL
- NPI 1134369663
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Wheeling, IL
- NPI 1720525678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780185600000",
"number": "1417628231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 N LECLAIRE AVE APT 3N",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606511545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4732 N AUSTIN AVE UNIT A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606303785",
"telephone_number": "773-501-4288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "ANGIE",
"credential": "M.ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-22",
"last_updated": "2026-05-31",
"certification_date": "2026-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.018054",
"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 May 31, 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.