Active NPI
Susan J Luiten
- Counselor
- Peoria, IL
National Provider Identifier
1912204066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.003803
- Practice address
- 7031 N Patton LN
Peoria, IL 61614-1918 - Phone
- (309) 369-9103
- Fax
- (309) 692-8775
- NPI assigned
- Feb 24, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.003803 | IL | Primary |
Addresses
Primary practice location
7031 N Patton LN
Peoria, IL 61614-1918
Mailing address
7031 N Patton LN
Peoria, IL 61614-1918
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178.003803 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298505600000",
"number": "1912204066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7031 N PATTON LN",
"city": "PEORIA",
"state": "IL",
"postal_code": "616141918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7031 N PATTON LN",
"city": "PEORIA",
"state": "IL",
"postal_code": "616141918",
"telephone_number": "309-369-9103",
"fax_number": "309-692-8775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUITEN",
"first_name": "SUSAN",
"middle_name": "J",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-24",
"last_updated": "2011-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.003803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.