Derek Robert Conn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

5801 N Pulaski Rd
Chicago, IL 60646-6007

Phone

(312) 744-1906

NPI assigned

Jun 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Progressive Psychological Healthcare SCGroup PAC ID 8527366939, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Progressive Psychological Healthcare, S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buffalo Grove, IL
  • NPI 1902287923
  Medicare reassignment Care Compare group NPD
• Marianna Tsaran MD SC

  • Specialist
  • Arlington Heights, IL
  • NPI 1134283203
  NPD (past)
• In Home Health, LLC

  dba ProMedica Hospice (Eau Claire)

  • Community Based Hospice Care Agency
  • Eau Claire, WI
  • NPI 1710692488
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1578826632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HARRIS DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891672",
            "telephone_number": "847-275-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466007",
            "telephone_number": "312-744-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "DEREK",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Conlon, MD
• Kevin Conlon, M.D.
• Kristin Conlon
• Marta A Conlon, L.AC.
• Alison Jordan Conn, MS, CGC
• Connect Care Trans LLC
• Connect Hearing, Inc.
• Connect Hearing, Inc.
• Connect Hearing, Inc.
• Connect Psychotherapy, PLLC

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.