Ideal Self, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IDEAL SELF, INC.

Practice address

5150 Landers Rd
Hoffman Estates, IL 60192-4500

Phone

(847) 468-1311

NPI assigned

Jul 22, 2007

Organization subpart

No

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

Authorized official

Name

Leslie Gaynor, LCPC, CH

Title

President

Phone

(847) 468-1311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1185062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185062400000",
    "number": "1841490463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 LANDERS RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601924500",
            "telephone_number": "847-468-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 LANDERS RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601924500",
            "telephone_number": "847-468-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL SELF, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-22",
        "last_updated": "2007-07-22",
        "status": "A",
        "authorized_official_last_name": "GAYNOR",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-468-1311",
        "authorized_official_credential": "LCPC, CH"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis R Humphrey, LCPC
• Samira Hussain, D.O.
• Syed Asif Hussain, D.P.M
• Syed Babar Hussain, MD
• Michelle Hyman, LCSW
• Skyler Ray Ignacio
• Quinette Iheanyichukwu
• Alexandra Ilina, RBT
• Illinois Counseling Centers LLC
• Illinois Health Solutions

• Community/Behavioral Health Agency in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.