Active NPI
Klara Suparman
- Mental Health Counselor
- Northbrook, IL
National Provider Identifier
1649963547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178.015549
- Practice address
- 900 Skokie Blvd Ste 255
Northbrook, IL 60062-4054 - Phone
- (312) 500-1895
- NPI assigned
- May 29, 2023
- Last updated
- May 29, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178.015549 | IL | Primary |
Addresses
Primary practice location
900 Skokie Blvd Ste 255
Northbrook, IL 60062-4054
Mailing address
900 Skokie Blvd
Northbrook, IL 60062-4012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 12, 2024 through Feb 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.015549 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685318400000",
"number": "1649963547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 SKOKIE BLVD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600624012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SKOKIE BLVD STE 255",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600624054",
"telephone_number": "312-500-1895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPARMAN",
"first_name": "KLARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-29",
"last_updated": "2023-05-29",
"certification_date": "2023-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178.015549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.