Active NPI
Claire Kubiesa, PH.D.
- Counseling Psychologist
- Great Lakes, IL
National Provider Identifier
1750851788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3614-57
- Practice address
- 3420 Illinois St
Great Lakes, IL 60088-3161 - Phone
- (847) 688-6755
- NPI assigned
- Dec 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3614-57 | WI | Primary |
Addresses
Primary practice location
3420 Illinois St
Great Lakes, IL 60088-3161
Mailing address
321 N Maple Ave
Elmhurst, IL 60126-2332
Phone (630) 464-4611
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3614-57 | WI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1750851788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 N MAPLE AVE",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601262332",
"telephone_number": "630-464-4611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 ILLINOIS ST",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "600883161",
"telephone_number": "847-688-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBIESA",
"first_name": "CLAIRE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-03",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "WI",
"license": "3614-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Lakes, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.