Active NPI
Link to Wellness
- Mental Health Counselor
- Burr Ridge, IL
National Provider Identifier
1679205439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- LINK TO WELLNESS
- Practice address
- 11S270 S Jackson St Ste 101
Burr Ridge, IL 60527-6823 - Phone
- (618) 401-7140
- NPI assigned
- Jun 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Foreman
- Title
- Credentialing
- Phone
- (630) 313-0069
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
11S270 S Jackson St Ste 101
Burr Ridge, IL 60527-6823
Mailing address
9138 Sherman Ave
Brookfield, IL 60513-1547
Phone (618) 401-7140
National Provider Directory
National Provider DirectoryLocations
11S270 S Jackson St
Ste 101
Burr Ridge, IL 60527
Phone (618) 401-7140
6362 S Cass Ave
Westmont, IL 60559
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Burr Ridge, IL
- NPI 1063933521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692230400000",
"number": "1679205439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9138 SHERMAN AVE",
"city": "BROOKFIELD",
"state": "IL",
"postal_code": "605131547",
"telephone_number": "618-401-7140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11S270 S JACKSON ST STE 101",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276823",
"telephone_number": "618-401-7140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINK TO WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-29",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A",
"authorized_official_last_name": "FOREMAN",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "630-313-0069"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.