Individual provider Active NPI

Jamie Sabo

  • Professional Counselor
  • Watseka, IL
National Provider Identifier
1760937007
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.011612 Issued in IL
Practice address
323 W Mulberry St
Watseka, IL 60970-1568
Phone
(815) 432-5241
Fax
(815) 432-4537
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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 178.011612 IL Primary

Addresses

Primary practice location

323 W Mulberry St
Watseka, IL 60970-1568

Mailing address

323 W Mulberry St
PO Box 322
Watseka, IL 60970-1568

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
I20240318000873 IL Practitioner - Mental Health Counselor 4284071994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Lisa Schwab, LLCGroup PAC ID 1850688557, 5 clinicians

Practice addresses (Care Compare)

4211 N Prospect Rd
Peoria Heights, IL 61616-7754
Phone (309) 691-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.011612ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Schwab, LLC Professional CurrentSince Feb 3, 2024 Accepting new patients

Locations

4211 N Prospect Rd
Peoria Hts, IL 61616
Phone (309) 691-5502

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1760937007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "address_2": "PO BOX 322",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568",
            "telephone_number": "815-432-5241",
            "fax_number": "815-432-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABO",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.