Individual provider Active NPI

Angela Adams Ali, PHD, LCPC, MFT, BCC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1588038517
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.009921 Issued in IL
Practice address
1505 E 53Rd St # 2E
Chicago, IL 60615-4509
Phone
(312) 371-0562
Fax
(773) 285-1726
NPI assigned
Nov 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 180.009921 IL Primary

Addresses

Primary practice location

1505 E 53Rd St # 2E
Chicago, IL 60615-4509

Mailing address

4072 S Lake Park Ave
Chicago, IL 60653-2525
Phone (312) 371-0562

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
I20241029000183 IL Practitioner - Mental Health Counselor 9133652241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1505 E 53Rd St
Chicago, IL 60615-4509
Phone (312) 487-3791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
180.009921ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Counseling & Consults Corporation Professional CurrentSince Aug 21, 2024 Accepting new patients

Locations

1505 E 53rd St
#2E
Chicago, IL 60615
Phone (312) 487-3791

1505 E 53rd St
Chicago, IL 60615
Phone (312) 487-3791

1505 E 53rd St
#2W
Chicago, IL 60615

Organizations & group practices 1

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": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1588038517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4072 S LAKE PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532525",
            "telephone_number": "312-371-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E 53RD ST # 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154509",
            "telephone_number": "312-371-0562",
            "fax_number": "773-285-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "ANGELA",
        "middle_name": "ADAMS",
        "name_prefix": "Dr.",
        "credential": "PHD, LCPC, MFT, BCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.