Active NPI
Philip Vedova
- Professional Counselor
- Downers Grove, IL
National Provider Identifier
1811523053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178011730
- Practice address
- 1001 Maple Ave
Downers Grove, IL 60515-4928 - Phone
- (630) 751-9908
- NPI assigned
- Mar 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178011730 | IL | Primary |
Addresses
Primary practice location
1001 Maple Ave
Downers Grove, IL 60515-4928
Mailing address
2711 Buckingham Dr Apt 207
Lisle, IL 60532-4272
Phone (630) 819-0198
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 |
|---|---|---|---|
| 178011730 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1811523053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2711 BUCKINGHAM DR APT 207",
"city": "LISLE",
"state": "IL",
"postal_code": "605324272",
"telephone_number": "630-819-0198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 MAPLE AVE",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605154928",
"telephone_number": "630-751-9908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEDOVA",
"first_name": "PHILIP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-19",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178011730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.