Individual provider Active NPI

Dana Wick, LCPC

  • Professional Counselor
  • Homer Glen, IL
National Provider Identifier
1639636566
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-014539 Issued in IL
Practice address
15915 S Crystal Creek Dr Ste E
Homer Glen, IL 60491-9381
Phone
(708) 288-4057
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 180-014539 IL Primary

Addresses

Primary practice location

15915 S Crystal Creek Dr Ste E
Homer Glen, IL 60491-9381

Mailing address

14928 Kilbourne Ave
Midlothian, IL 60445-3234
Phone (708) 288-4057

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
I20250916004227 IL Practitioner - Mental Health Counselor 2567966260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15915 S Crystal Creek Dr
Suite E
Homer Glen, IL 60491-1938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-014539ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Prosper Single Specialty CurrentSince Jul 1, 2025 Accepting new patients

Locations

15915 S Crystal Creek Dr
Ste E
Homer Glen, IL 60491
Phone (708) 288-4057

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1639636566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14928 KILBOURNE AVE",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604453234",
            "telephone_number": "708-288-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15915 S CRYSTAL CREEK DR STE E",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919381",
            "telephone_number": "708-288-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICK",
        "first_name": "DANA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-014539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.