Individual provider Active NPI

Kristin Fasshauer, QMHP

  • Professional Counselor
  • Franklin Park, IL
National Provider Identifier
1477119576
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180015344 Issued in IL
Practice address
10001 Grand Ave Ste 1
Franklin Park, IL 60131-2564
Phone
(847) 451-8303
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 180015344 IL Primary

Addresses

Primary practice location

10001 Grand Ave Ste 1
Franklin Park, IL 60131-2564

Mailing address

10001 Grand Ave Ste 1
Franklin Park, IL 60131-2564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429000720 IL Practitioner - Mental Health Counselor 6901322353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leyden Family Service and Mental Health CenterGroup PAC ID 3274570569, 8 clinicians
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

10001 Grand Ave
Franklin Park, IL 60131-2563
Phone (847) 451-0330

825 Carillon Dr
Bartlett, IL 60103-4581
Phone (630) 372-1983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Leyden Family Service & Mental Health Center CurrentSince Apr 18, 2025 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

825 Carillon Dr
Bartlett, IL 60103
Phone (630) 372-1983

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

10001 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-0330

10001 Grand Ave
Ste 1
Franklin Park, IL 60131
Phone (847) 451-0330

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.

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1477119576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 GRAND AVE STE 1",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601312564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 GRAND AVE STE 1",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601312564",
            "telephone_number": "847-451-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSHAUER",
        "first_name": "KRISTIN",
        "credential": "QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180015344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Park, IL

Sources for this page

Verify at the official NPI Registry.