Sergio D Hernandez, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010682 Issued in IL

Practice address

1740 Ridge Ave
Evanston, IL 60201-5918

Phone

(872) 216-0574

NPI assigned

Jan 22, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: sergio.hernandez.1@27315.direct.athenahealth.com

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.

• Tapestry 360 Health

  dba Heartland Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1407981392
  NPD (past)

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1720596950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "872-216-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015918",
            "telephone_number": "872-216-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "SERGIO",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy S Heo, DO
• Stephanie Ann Heraty, MD
• Angel Custodio Hernandez, APN-CNP
• Jose Luis Hernandez, LMFT
• Lidia Hernandez, ACNP
• Sherita Tina Lakira Hernton, PA-C
• Linda Susan Herreid, PSY.D.
• Thomas A Herriges, M.D
• Maxwell Hersman, APN-CRNA
• Eleanor Margaret Herzberg

• Professional Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.