Individual provider Active NPI

Robert Wise, LCPC

  • Professional Counselor
  • Elgin, IL
National Provider Identifier
1861338550
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180007007 Issued in IL
Practice address
1845 Grandstand PL
Elgin, IL 60123-6603
Phone
(847) 695-0484
NPI assigned
Apr 27, 2026
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180007007 IL Primary

Addresses

Primary practice location

1845 Grandstand PL
Elgin, IL 60123-6603

Mailing address

1051 W Park Place Dr
Bartlett, IL 60103-4414
Phone (773) 960-9538

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529000797 IL Practitioner - Mental Health Counselor 8426528555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1051 W Park Place Dr
Bartlett, IL 60103-4414

1845 Grandstand PL
Elgin, IL 60123-4982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180007007ILMDProfessional Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1861338550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 W PARK PLACE DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034414",
            "telephone_number": "773-960-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ROBERT",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.