Individual provider Active NPI

Grace Pelzer

  • Professional Counselor
  • Northfield, IL
National Provider Identifier
1902489552
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.014034 Issued in IL
Practice address
540 W Frontage Rd Ste 2215
Northfield, IL 60093-1228
Phone
(847) 848-0697
NPI assigned
May 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.016306 IL
Professional Counselor 101YP2500X 180.014034 IL Primary

Addresses

Primary practice location

540 W Frontage Rd Ste 2215
Northfield, IL 60093-1228

Mailing address

3446 N Damen Ave # 1
Chicago, IL 60618-6106
Phone (815) 228-0782

Other practice location 1

310 Happ Rd Ste 205A
Northfield, IL 60093-3457
Phone (847) 848-0697

Other names 1

  • Grace Lethiot Former name

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

State licenses

LicenseStateTypeSpecialty
178.016306ILMDProfessional Counselor
180.014034ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1902489552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3446 N DAMEN AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186106",
            "telephone_number": "815-228-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W FRONTAGE RD STE 2215",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931228",
            "telephone_number": "847-848-0697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Happ Rd Ste 205A",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600933457",
            "country_code": "US",
            "telephone_number": "847-848-0697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELZER",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.016306",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "LETHIOT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.