Active NPI
Iconpsychologies
- Professional Counselor
- Burr Ridge, IL
National Provider Identifier
1578994489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 036.117531
- Legal business name
- ICONPSYCHOLOGIES
- Practice address
- 8961 Enclave Dr
Burr Ridge, IL 60527-8394 - Phone
- (312) 342-6066
- NPI assigned
- Dec 2, 2013
- Last updated
- Dec 2, 2013
- Organization subpart
- Yes
- Parent organization
- DOCTORS UNLIMITED SC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Soberekon Melvin Koko, MD
- Title
- President/Ceo
- Phone
- (773) 933-9300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 036.117531 | IL | Primary |
Addresses
Primary practice location
8961 Enclave Dr
Burr Ridge, IL 60527-8394
Mailing address
1750 E 87TH St
Suit 109
Chicago, IL 60617-2713
Phone (773) 933-9300
National Provider Directory
National Provider Directory- Part of
- Integracare
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Neurology Physician
- Chicago, IL
- NPI 1992918866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385942400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1385942400000",
"number": "1578994489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 E 87TH ST",
"address_2": "SUIT 109",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606172713",
"telephone_number": "773-933-9300",
"fax_number": "773-933-9302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8961 ENCLAVE DR",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605278394",
"telephone_number": "312-342-6066"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICONPSYCHOLOGIES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DOCTORS UNLIMITED SC",
"enumeration_date": "2013-12-02",
"last_updated": "2013-12-02",
"status": "A",
"authorized_official_last_name": "KOKO",
"authorized_official_first_name": "SOBEREKON",
"authorized_official_middle_name": "MELVIN",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "773-933-9300",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "036.117531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.