Organization Active NPI

Constance a Fullilove PHD LTD

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1932022134
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CONSTANCE A FULLILOVE PHD LTD
Practice address
4742 S Ellis Ave Apt 1
Chicago, IL 60615-1821
Phone
(312) 560-1808
NPI assigned
Aug 3, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Authorized official

Name
Constance A Fullilove PHD LTD, PH.D.
Title
Owner
Phone
(312) 560-1808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4742 S Ellis Ave Apt 1
Chicago, IL 60615-1821

Mailing address

4742 S Ellis Ave Apt 1
Chicago, IL 60615-1821
Phone (312) 560-1808

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790208000000",
    "number": "1932022134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4742 S ELLIS AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606151821",
            "telephone_number": "312-560-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4742 S ELLIS AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606151821",
            "telephone_number": "312-560-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTANCE A FULLILOVE PHD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A",
        "authorized_official_last_name": "FULLILOVE PHD LTD",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-560-1808",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.