Rysa Shavonne Koch, M.A., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.017269 Issued in IL

Practice address

PO Box 251
Flossmoor, IL 60422-0251

Phone

(312) 521-0644

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rysa Shavonne Santos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Root & Resonance PLLC

  • Mental Health Counselor
  • Flossmoor, IL
  • NPI 1124967997
  NPD Authorized official

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1841860194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 STERLING AVE",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221241",
            "telephone_number": "954-913-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 251",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604220251",
            "telephone_number": "312-521-0644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1757 N Kimball Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606474805",
            "country_code": "US",
            "telephone_number": "954-913-9255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "RYSA",
        "middle_name": "SHAVONNE",
        "credential": "M.A., LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.017269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYSA",
            "last_name": "SANTOS",
            "middle_name": "SHAVONNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Kimble, CLC
• Bernadette King
• Lakeisha Kirby, LPC
• William G. Klipfel, M.D.
• Dale William Klooster, LCSW
• Christopher Koenig, PA-C
• Kimberly Kramer, RD, LDN
• Margaret Krol, LCSW
• Kimberly R Kruczek, D.O
• Lindsey Kulma, M.H.S., CCC-SLP/L

• Professional Counselor in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.