Individual provider Active NPI

Marian Etta Towns

  • Counselor
  • Chicago, IL
National Provider Identifier
1497365415
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
6417 W Irving Park Rd
Chicago, IL 60634-2437
Phone
(773) 777-7112
Fax
(773) 777-7611
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IL Primary

Addresses

Primary practice location

6417 W Irving Park Rd
Chicago, IL 60634-2437

Mailing address

6406 S Minerva Ave Apt GDN
Chicago, IL 60637-3666
Phone (847) 644-2896

Other identifiers 1

IdentifierTypeStateIssuer
1770704579MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chicago

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

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Outreach Services PastSince Aug 9, 2020 Accepting new patients
Youth Outreach Services PastSince Aug 9, 2020 Accepting new patients

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": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1497365415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 S MINERVA AVE APT GDN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606373666",
            "telephone_number": "847-644-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342437",
            "telephone_number": "773-777-7112",
            "fax_number": "773-777-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNS",
        "first_name": "MARIAN",
        "middle_name": "ETTA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770704579",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "6417 W Irving Park Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606342437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Aug 4, 2020; 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.