Active NPI
Shannon Chrismore
- Mental Health Counselor
- Aurora, IL
National Provider Identifier
1669263364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180003749
- Practice address
- 1330 N Lake St
Aurora, IL 60506-2410 - Phone
- (630) 907-3712
- Fax
- (630) 801-5616
- NPI assigned
- May 14, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180003749 | IL | Primary |
Addresses
Primary practice location
1330 N Lake St
Aurora, IL 60506-2410
Mailing address
1330 N Lake St
Aurora, IL 60506-2410
Phone (630) 907-3712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180003749 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747180800000",
"number": "1669263364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 N LAKE ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605062410",
"telephone_number": "630-907-3712",
"fax_number": "630-801-5616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 N LAKE ST",
"city": "AURORA",
"state": "IL",
"postal_code": "605062410",
"telephone_number": "630-907-3712",
"fax_number": "630-801-5616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISMORE",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-14",
"last_updated": "2025-05-14",
"certification_date": "2025-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180003749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.