Individual provider Active NPI

Kayla Pedraza, LCPC

  • Professional Counselor
  • Oak Park, IL
National Provider Identifier
1700498003
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
17016141 Issued in IL
Practice address
715 Lake St Ste 400
Oak Park, IL 60301-1413
Phone
(773) 312-3612
NPI assigned
Aug 18, 2020
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 17016141 IL Primary

Addresses

Primary practice location

715 Lake St Ste 400
Oak Park, IL 60301-1413

Mailing address

715 Lake St Ste 400
Oak Park, IL 60301-1413
Phone (773) 312-3612

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
I20240417000855 IL Practitioner - Mental Health Counselor 6406295906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovative Counseling Partners LLCGroup PAC ID 0749605830, 14 clinicians

Practice addresses (Care Compare)

715 Lake St
Suite 273
Oak Park, IL 60301-1411
Phone (773) 312-3612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17016141ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Counseling Partners LLC CurrentSince Mar 4, 2024 Accepting new patients

Locations

3047 N Lincoln Ave
Unit 400
Chicago, IL 60657
Phone (773) 494-5055

715 Lake St
Ste 273
Oak Park, IL 60301
Phone (708) 848-3800

715 Lake St
Ste 800
Oak Park, IL 60301
Phone (708) 386-8145

7222 W Cermak Rd
Ste 703
Riverside, IL 60546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1700498003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 LAKE ST STE 400",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011413",
            "telephone_number": "773-312-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST STE 400",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011413",
            "telephone_number": "773-312-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "KAYLA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "17016141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.