Active NPI
Nickolas G. Shizas, LCPC
- Professional Counselor
- Orland Park, IL
National Provider Identifier
1821275249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-005728
- Practice address
- 13820 S 88TH Ave
Orland Park, IL 60462-1645 - Phone
- (708) 308-0004
- NPI assigned
- Jan 28, 2008
- 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 | 180-005728 | IL | Primary |
Addresses
Primary practice location
13820 S 88TH Ave
Orland Park, IL 60462-1645
Mailing address
13820 S 88TH Ave
Orland Park, IL 60462-1645
Phone (708) 308-0004
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 |
|---|---|---|---|
| 180-005728 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1821275249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13820 S 88TH AVE",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604621645",
"telephone_number": "708-308-0004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13820 S 88TH AVE",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604621645",
"telephone_number": "708-308-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIZAS",
"first_name": "NICKOLAS",
"middle_name": "G.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-28",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-005728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.