Mark H Pelech, LSW CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

29984 Issued in IL

Practice address

10402 S Cicero Ave
Oak Lawn, IL 60453-4704

Phone

(708) 422-2898

NPI assigned

Jul 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1427601871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 W LAKEVIEW CT",
            "address_2": "UNIT 1A",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-528-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10402 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534704",
            "telephone_number": "708-422-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELECH",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LSW CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "29984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "shereandassociates@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "HIE",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10402 S Cicero Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604534704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.