Active NPI
Patricia A Sugrue, NCTMB
- Professional Counselor
- Chicago, IL
National Provider Identifier
1841498490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.014900
- Practice address
- 3234 W Fullerton Ave
Chicago, IL 60647-2594 - Phone
- (773) 466-9882
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 227.000757 | IL | |
| Professional Counselor | 101YP2500X | 180.014900 | IL | Primary |
Addresses
Primary practice location
3234 W Fullerton Ave
Chicago, IL 60647-2594
Mailing address
1531 W Fargo Ave # 2
Chicago, IL 60626-7079
Phone (773) 989-7562
Other practice location 1
1531 W Fargo Ave # 2
Chicago, IL 60626-7079
Phone (773) 989-7562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.014900 | IL | MD | Professional Counselor |
| 227.000757 | IL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Five Point Holistic Health | Professional | Current | Accepting new patients |
Locations
3234 W Fullerton Ave
Chicago, IL 60647
Phone (773) 466-9882
2866 N Milwaukee Ave
Chicago, IL 60618
Phone (773) 466-9882
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1841498490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1531 W FARGO AVE # 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606267079",
"telephone_number": "773-989-7562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3234 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472594",
"telephone_number": "773-466-9882"
}
],
"practiceLocations": [
{
"address_1": "1531 W Fargo Ave # 2",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606267079",
"country_code": "US",
"telephone_number": "773-989-7562",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUGRUE",
"first_name": "PATRICIA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "NCTMB",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2022-12-05",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "227.000757",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.014900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.