Brad Burklow, MS. LCPC – Mental Health Counselor

Key facts

NPI: 1679912042
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: 180.004663 (IL)
Practice address: 1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone: (618) 273-3326
Fax: (618) 273-3585
NPI assigned: Jun 19, 2013
Sex: Male
Sole proprietor: No

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.

Revelations RX PLLC Psychiatric/Mental Health Nurse Practitioner · Naperville, IL · NPI 1265124846

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
180.004663	IL	MD	Mental Health Counselor

Practice roles

Organization	Specialty	Status	New patients
Revelations RX PLLC		Current since Jan 31, 2024	Accepting new patients

Locations

640 N River Rd
Ste 108
Naperville, IL 60563
Phone (630) 359-8951

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	180.004663	IL	Yes

Addresses

Primary practice location

1412 US Highway 45 N
Eldorado, IL 62930-3766

Mailing address

1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone (618) 273-3326

Other providers in Eldorado, IL

All providers in Eldorado, IL · Mental Health Counselor in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.