Individual provider Active NPI

Grace Varghese

  • Professional Counselor
  • Northbrook, IL
National Provider Identifier
1689016289
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180011272 Issued in IL
Practice address
3330 Dundee Rd Ste C2
Northbrook, IL 60062-2328
Phone
(847) 577-1501
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178008473 IL
Professional Counselor 101YP2500X 180011272 IL Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

3330 Dundee Rd Ste C2
Northbrook, IL 60062-2328

Mailing address

3330 Dundee Rd Ste C2
Northbrook, IL 60062-2328
Phone (847) 577-1501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260106003314 IL Practitioner - Mental Health Counselor 1153817473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stellar Clinic CT PLLCGroup PAC ID 0840633368, 46 clinicians

Practice addresses (Care Compare)

111 N Wabash Ave
Chicago, IL 60602-2060
Phone (248) 704-5837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178008473ILMDProfessional Counselor
180011272ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Clinic CT PLLC CurrentSince Oct 30, 2025 Accepting new patients
Lake-Cook Psychologists and Counseling Associates PastSince Jan 4, 2026 Accepting new patients
Vadim Edelstein MD LTD PastSince Jan 4, 2026 Accepting new patients

Locations

440 N Barranca Ave
Covina, CA 91723
Phone (510) 210-5030

111 N Wabash Ave
Ste 100
Chicago, IL 60602
Phone (312) 219-1597

111 N Wabash Ave
Chicago, IL 60602
Phone (248) 704-5837

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1689016289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 DUNDEE RD STE C2",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622328",
            "telephone_number": "847-577-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 DUNDEE RD STE C2",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622328",
            "telephone_number": "847-577-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178008473",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011272",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.