Otte Practice PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

OTTE PRACTICE PLLC

Doing business as

Ellie Mental Health - Naperville

Practice address

1804 N Naper Blvd Ste 250
Naperville, IL 60563-8830

Phone

(708) 297-1723

NPI assigned

Oct 18, 2022

Last updated

Sep 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elliotte G Lasley

Title

Owner

Phone

(312) 401-1428

Specialties & licenses 6

Addresses

Other names 1

• Ellie Mental Health - Naperville Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Ellie Mental Health - Naperville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Otte Practice PLLC

  • Family Nurse Practitioner
  • Naperville, IL
  • NPI 1164252896
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin Anna Nelson, MSW, LCSW

  • Clinical Social Worker
  • Naperville, IL
  • NPI 1164959151

  Mental Health

  Medicare reassignment Care Compare group NPD
• Gloria Maria Tovar, MA, LCPC

  • Professional Counselor
  • Westmont, IL
  • NPI 1437824257

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Matthew J Toman, APN

  • Family Nurse Practitioner
  • Naperville, IL
  • NPI 1750894952
  Medicare reassignment NPD
• Brian Joseph Wagner, LCSW

  • Clinical Social Worker
  • Wheaton, IL
  • NPI 1336926393
  Medicare reassignment NPD
• Heather Michelle Olsson, MA, LCPC

  • Professional Counselor
  • Naperville, IL
  • NPI 1316227440

  Mental Health

  NPD

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1477279651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 N NAPER BLVD STE 250",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638830",
            "telephone_number": "708-297-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 N NAPER BLVD STE 250",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638830",
            "telephone_number": "708-297-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTE PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "LASLEY",
        "authorized_official_first_name": "ELLIOTTE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-401-1428"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health - Naperville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marylouise Josette Osetek, APN
• James P. Ostrenga, M.D.
• Stephanie Jean Ott, LPC
• Otte Practice LLC (Just Breathe Mental Health)
• Otte Practice PLLC
• Otte Therapy LLC (Just Breathe Mental Health)
• Jennifer Otto, LPC
• Kimberly M Otto, APN
• Mark R. Ottolin, M.D.
• Domenica D. Ottolino

• Mental Health Clinic/Center (Including Community Mental Health Center) in Naperville, IL
• Providers in Naperville, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.