Active NPI
Dana Wick, LCPC
- Professional Counselor
- Homer Glen, IL
National Provider Identifier
1639636566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-014539
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Professional Counselor | 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180-014539 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope and Prosper | Single Specialty | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.