Active NPI
Kiya Immergluck, LCPC
- Counselor
- Chicago, IL
National Provider Identifier
1437470846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 4200 N Marine Dr
#405
Chicago, IL 60613-1743 - Phone
- (773) 880-5492
- NPI assigned
- Jun 20, 2010
- Last updated
- Jun 20, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | IL | Primary |
Addresses
Primary practice location
4200 N Marine Dr
#405
Chicago, IL 60613-1743
Mailing address
4200 N Marine Dr
#405
Chicago, IL 60613-1743
Phone (773) 880-5492
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276992000000",
"number": "1437470846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 N MARINE DR",
"address_2": "#405",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131743",
"telephone_number": "773-880-5492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 N MARINE DR",
"address_2": "#405",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606131743",
"telephone_number": "773-880-5492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMERGLUCK",
"first_name": "KIYA",
"name_prefix": "Dr.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-20",
"last_updated": "2010-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": null,
"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 Jun 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.