NPIMap

Individual provider Active NPI

Frank Charles Ponziano Jr., A.A.S. C.A.D.C.

  • Counselor
  • Northfield, IL
National Provider Identifier
1427297787
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
211 Waukegan Rd
St.100
Northfield, IL 60093-2757
Phone
(847) 446-2270
Fax
(847) 446-2172
NPI assigned
Feb 10, 2009
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 26662 IL
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

211 Waukegan Rd
St.100
Northfield, IL 60093-2757

Mailing address

2235 N 75TH Ave Apt G
Elmwood Park, IL 60707-2602
Phone (773) 981-0620

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
Associate of Applied Science

State licenses

LicenseStateTypeSpecialty
26662ILMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mind, Body and Spirit Counseling & Consultation LLC Current Accepting new patients
North Shore Adolescent Recovery Center 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, 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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1427297787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 N 75TH AVE APT G",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607072602",
            "telephone_number": "773-981-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 WAUKEGAN RD",
            "address_2": "ST.100",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932757",
            "telephone_number": "847-446-2270",
            "fax_number": "847-446-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONZIANO",
        "first_name": "FRANK",
        "middle_name": "CHARLES",
        "name_prefix": "Prof.",
        "name_suffix": "Jr.",
        "credential": "A.A.S. C.A.D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "26662",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.