Mark Anthony Maciuszek, MA LCPC
Individual provider Active NPI Mental Health Counselor · Summit, IL
NPI 1508931163 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508931163
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 7424 Archer Rd
Summit, IL 60501 - Phone
- (708) 458-8228
- Fax
- (708) 458-9177
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of Dupage Department of Health
Practice addresses (Care Compare)
111 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 682-7400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240125002522 | IL | Practitioner - Mental Health Counselor | 6608229679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180005661 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Dupage Department of Health | Current | Accepting new patients | |
| County of Dupage Department of Health | Current |
Accepting new patients | |
| County of Dupage Department of Health | Current |
Accepting new patients |
Locations
111 N County Farm Rd
Wheaton, IL 60187
Phone (630) 627-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IL | Yes |
Addresses
Primary practice location
7424 Archer Rd
Summit, IL 60501
Mailing address
1437 Morgan Avenue
Lagrange Park, IL 60526
Phone (708) 354-2833
Other providers in Summit, IL
- KM Physical Therapy PC
- John F. Kozal
- Tina Marie Lakatos
- Carmen Luckett
- Annemarie Luperini
- Tiara Magee
- Mark J. Gagnon, LTD
- Metropolitan Health Care Providers LLC
- D'Andra Mixon-Walker
- Mobile Lab Services Co
All providers in Summit, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.