Ryan Nickolas Edwards, NONE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.014360 Issued in IL

Practice address

600 Enterprise Dr Ste 220
Oak Brook, IL 60523

Phone

(844) 632-7736

Fax

(888) 972-3621

NPI assigned

May 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mosaic Counseling and Wellness LLC

  dba Mosaic Counseling and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
  • NPI 1851065502
  Medicare reassignment NPD
• Seth a. Eappen, MD PLLC

  • Child & Adolescent Psychiatry Physician
  • Oak Brook, IL
  • NPI 1639610553
  NPD (past)

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1740717305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 W BELDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473223",
            "telephone_number": "630-656-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ENTERPRISE DR STE 220",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "844-632-7736",
            "fax_number": "888-972-3621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 N Claremont Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221702",
            "country_code": "US",
            "telephone_number": "312-633-5890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1431 N Claremont Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221702",
            "country_code": "US",
            "telephone_number": "312-633-5890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RYAN",
        "middle_name": "NICKOLAS",
        "credential": "NONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.014360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Duveneck, APRN
• Dynamic Physical Therapy (Body Gears - Oak Brook)
• E Eliot Benezra MDSC
• Seth Ashok Eappen, M.D.
• Jennifer Renee Earnest, LCPC, NCC, CCMHC
• Mary Ann Egan-Kramer, BSN,DDS
• Ehs Home Health Care Service Inc (Advocate Home Health Services)
• Meg Eifrig, LCPC
• Samantha Eiler
• Emily A. Elmore, LCSW

• Mental Health Counselor in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.