Individual provider Active NPI

Eileen Niemiera, PHD. LC.P.C.

  • Mental Health Counselor
  • Oak Lawn, IL
National Provider Identifier
1477672459
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180004583 Issued in IL
Practice address
10610 S Cicero Ave Ste 4
Oak Lawn, IL 60453-5298
Phone
(708) 364-7046
Fax
(708) 364-7048
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180004583 IL Primary

Addresses

Primary practice location

10610 S Cicero Ave Ste 4
Oak Lawn, IL 60453-5298

Mailing address

5101 W 105TH St
Oak Lawn, IL 60453-5122
Phone (708) 278-2839

Other identifiers 1

IdentifierTypeStateIssuer
180004583OtherILBCBSIL

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

State licenses

LicenseStateTypeSpecialty
180004583ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1477672459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 W 105TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535122",
            "telephone_number": "708-278-2839",
            "fax_number": "708-422-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 S CICERO AVE STE 4",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535298",
            "telephone_number": "708-364-7046",
            "fax_number": "708-364-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMIERA",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "PHD.   LC.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180004583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "180004583",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.