Individual provider Active NPI

Craig K Boura, MA, LCPC

  • Mental Health Counselor
  • Downers Grove, IL
National Provider Identifier
1699844795
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180-002214 Issued in IL
Practice address
6912 Main St
Suite 28
Downers Grove, IL 60516-3447
Phone
(630) 474-4780
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-002214 IL Primary

Addresses

Primary practice location

6912 Main St
Suite 28
Downers Grove, IL 60516-3447

Mailing address

6912 Main St
Suite 28
Downers Grove, IL 60516-3447
Phone (630) 474-4780

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180-002214ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Counseling Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1699844795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6912 MAIN ST",
            "address_2": "SUITE 28",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163447",
            "telephone_number": "630-474-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 MAIN ST",
            "address_2": "SUITE 28",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163447",
            "telephone_number": "630-474-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURA",
        "first_name": "CRAIG",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-002214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.