Active NPI
Philip James Kocisko, LPC
- Counselor
- Saint Charles, IL
National Provider Identifier
1801126941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178005868
- Practice address
- 3140 W. Route 64
Saint Charles, IL 60175 - Phone
- (630) 587-5631
- NPI assigned
- Jan 13, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178005868 | IL | Primary |
Addresses
Primary practice location
3140 W. Route 64
Saint Charles, IL 60175
Mailing address
3140 W. Route 64
Saint Charles, IL 60175
Phone (630) 587-5631
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178005868 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1801126941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3140 W. ROUTE 64",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "60175",
"telephone_number": "630-587-5631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3140 W. ROUTE 64",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "60175",
"telephone_number": "630-587-5631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCISKO",
"first_name": "PHILIP",
"middle_name": "JAMES",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-13",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178005868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.