NPIMap

Organization Active NPI

Cognitive Clinic P C

  • Professional Counselor
  • Palos Hills, IL
National Provider Identifier
1770936585
Registry record updated Jun 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.010304 Issued in IL
Legal business name
COGNITIVE CLINIC P C
Practice address
9944 S Roberts Rd Ste 202
Palos Hills, IL 60465-1558
Phone
(708) 586-9050
Fax
(708) 581-3939
NPI assigned
Jul 16, 2016
Last updated
Jun 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2026

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

Authorized official

Name
Carla CarterNPI 1437589660
Title
President
Phone
(708) 267-7700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.010304 IL Primary

Addresses

Primary practice location

9944 S Roberts Rd Ste 202
Palos Hills, IL 60465-1558

Mailing address

9944 S Roberts Rd Ste 202
Palos Hills, IL 60465-1558
Phone (708) 586-9050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240627002632 IL Part B Supplier - Clinic/Group Practice 9032653357 Receives reassigned benefits from 4 practitioners
Practice locations: Palos Hills, IL

National Provider Directory

National Provider Directory

Locations

9944 S Roberts Rd
Ste 202
Palos Hills, IL 60465
Phone (708) 586-9050

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782000000000",
    "number": "1770936585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9944 S ROBERTS RD STE 202",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651558",
            "telephone_number": "708-586-9050",
            "fax_number": "708-581-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9944 S ROBERTS RD STE 202",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651558",
            "telephone_number": "708-586-9050",
            "fax_number": "708-581-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-16",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-267-7700"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.