Individual provider Active NPI

Miracle Williams

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
National Provider Identifier
1699681106
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Practice address
204 N Genesee St
Waukegan, IL 60085-4262
Phone
(847) 441-5600
NPI assigned
Aug 24, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X IL
Family Psychologist 103TF0000X IL
Mental Health Counselor 101YM0800X IL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X IL Primary

Addresses

Primary practice location

204 N Genesee St
Waukegan, IL 60085-4262

Mailing address

3105 N Luna Ave
Chicago, IL 60641-4849
Phone (773) 301-4193

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788566400000",
    "number": "1699681106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 N LUNA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414849",
            "telephone_number": "773-301-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N GENESEE ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854262",
            "telephone_number": "847-441-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MIRACLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.