Sandra Derks, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-004503 Issued in IL

Practice address

1401 McHenry Rd
Suite #122
Buffalo Grove, IL 60089-1382

Phone

(847) 913-0393

Fax

(847) 913-9630

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Quest Counseling and Consultation Center, LLC

  • Mental Health Counselor
  • Madison, WI
  • NPI 1912499351
  Medicare reassignment NPD Authorized official
• Arbor Counseling Center,LTD

  • Clinical Social Worker
  • Buffalo Grove, IL
  • NPI 1164479945
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1821162983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MCHENRY RD",
            "address_2": "SUITE #122",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891382",
            "telephone_number": "847-913-0393",
            "fax_number": "847-913-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MCHENRY RD",
            "address_2": "SUITE #122",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891382",
            "telephone_number": "847-913-0393",
            "fax_number": "847-913-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKS",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-004503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Jane Demchenko
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• Stephen Denton, PT
• Emalee Depa
• Derick Dermatology, PLLC
• Parita Desai, PHARM D
• Michelle Digiovanni
• Ruiying Ding, PH.D.
• Direct Medical Supply Inc
• Christine Dits

• Professional Counselor in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.