Individual provider Active NPI

Bobby J Wood, LCPC

  • Mental Health Counselor
  • Downers Grove, IL
National Provider Identifier
1922343532
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.008378 Issued in IL
Practice address
1341 Warren Ave
Downers Grove, IL 60515-3437
Phone
(630) 719-5454
Fax
(630) 719-1263
NPI assigned
Dec 7, 2012
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.008378 IL
Mental Health Counselor 101YM0800X 180.008378 IL Primary
Professional Counselor 101YP2500X 180008379 IL

Addresses

Primary practice location

1341 Warren Ave
Downers Grove, IL 60515-3437

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

2615 Edwards St
Alton, IL 62002-3915
Phone (618) 462-2331

Other practice location 2

50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone (618) 877-4420

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20240111000240 IL Practitioner - Mental Health Counselor 1850742123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1341 Warren Ave
Downers Grove, IL 60515-3437
Phone (630) 719-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.008378ILMDCounselor
180008379ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc. CurrentSince Jan 1, 2024 Accepting new patients
Chestnut Health Systems Inc CurrentSince Jan 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 2, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 2, 2024 Accepting new patients

Locations

12 N 64th St
Belleville, IL 62223
Phone (618) 397-0900

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1341 Warren Ave
Downers Grove, IL 60515
Phone (630) 275-1125

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

448 Wylie Dr
Normal, IL 61761
Phone (844) 973-6887

Organizations & group practices 4

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": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1922343532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 WARREN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153437",
            "telephone_number": "630-719-5454",
            "fax_number": "630-719-1263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Edwards St",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620023915",
            "country_code": "US",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-2504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Northgate Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620406805",
            "country_code": "US",
            "telephone_number": "618-877-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "BOBBY",
        "middle_name": "J",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-07",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.008378",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008378",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1341 Warren Ave",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605153437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.