Active NPI
Michelle L. Desideri-Sojka, M.A., L.C.P.C.
- Professional Counselor
- Berwyn, IL
National Provider Identifier
1841423563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180004102
- Practice address
- 6412 27TH St
Berwyn, IL 60402-2755 - Phone
- (708) 484-7400
- Fax
- (708) 484-7492
- NPI assigned
- Aug 27, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180004102 | IL | Primary |
Addresses
Primary practice location
6412 27TH St
Berwyn, IL 60402-2755
Mailing address
6412 27TH St
Berwyn, IL 60402-2755
Phone (708) 484-7400
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180004102 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251331200000",
"number": "1841423563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6412 27TH ST",
"city": "BERWYN",
"state": "IL",
"postal_code": "604022755",
"telephone_number": "708-484-7400",
"fax_number": "708-484-7492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6412 27TH ST",
"city": "BERWYN",
"state": "IL",
"postal_code": "604022755",
"telephone_number": "708-484-7400",
"fax_number": "708-484-7492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESIDERI-SOJKA",
"first_name": "MICHELLE",
"middle_name": "L.",
"name_prefix": "Mrs.",
"credential": "M.A., L.C.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-27",
"last_updated": "2009-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180004102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.