Active NPI
David Joseph Kinzer, M.A. LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1659389047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 2525 W Peterson Ave
Suite 12
Chicago, IL 60659-4108 - Phone
- (773) 765-0604
- Fax
- (773) 765-0622
- NPI assigned
- Aug 3, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
2525 W Peterson Ave
Suite 12
Chicago, IL 60659-4108
Mailing address
1928 W Winona St
3
Chicago, IL 60640-2609
Phone (773) 765-0604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
330 Lincoln Ave
Iron River, MI 49935-8452
Phone (718) 298-4375
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180005440 | IL | MD | Professional Counselor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Iron River, MI
- NPI 1548995608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659389047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1928 W WINONA ST",
"address_2": "3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402609",
"telephone_number": "773-765-0604",
"fax_number": "773-765-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 W PETERSON AVE",
"address_2": "SUITE 12",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606594108",
"telephone_number": "773-765-0604",
"fax_number": "773-765-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINZER",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "M.A. LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.