Individual provider Active NPI

Michael Luetkens, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1568077378
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.017905 Issued in IL
Practice address
2401 W Ohio St Ste NE
Chicago, IL 60612-1266
Phone
(630) 728-1744
NPI assigned
Sep 9, 2020
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.017905 IL Primary

Addresses

Primary practice location

2401 W Ohio St Ste NE
Chicago, IL 60612-1266

Mailing address

2401 W Ohio St Ste NE
Chicago, IL 60612-1266
Phone (630) 724-1744

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
I20240905001217 IL Practitioner - Mental Health Counselor 9537503362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180.017905ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Integrated, LLC Professional CurrentSince Jul 24, 2024 Accepting new patients
Mind Body Co-Op Mental Health CurrentSince Oct 1, 2022 Accepting new patients
Mind Body Co-Op Professional CurrentSince Aug 1, 2022 Accepting new patients
Grace Integrated PLLC PastSince Nov 24, 2024 Accepting new patients

Locations

30 N Michigan Ave
Ste 424
Chicago, IL 60602
Phone (312) 279-9981

125 Windsor Dr
Ste 113
Oak Brook, IL 60523
Phone (630) 728-1744

414 Plaza Dr
Ste 301
Westmont, IL 60559
Phone (630) 728-1744

Interoperability endpoints

  • Direct secure messaging: mindbodycoop.michaelleutkens@147350.advancedmd-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1568077378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W OHIO ST STE NE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121266",
            "telephone_number": "630-724-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W OHIO ST STE NE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121266",
            "telephone_number": "630-728-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETKENS",
        "first_name": "MICHAEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.017905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.