Individual provider Active NPI

Tara Turner I, 19935

  • Addiction (Substance Use Disorder) Counselor
  • East Hazel Crest, IL
National Provider Identifier
1932563756
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
19935 Issued in IL
Practice address
1909 Cheker SQ
East Hazel Crest, IL 60429-1442
Phone
(708) 647-3333
Fax
(708) 922-2062
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19935 IL Primary

Addresses

Primary practice location

1909 Cheker SQ
East Hazel Crest, IL 60429-1442

Mailing address

1909 Cheker SQ
East Hazel Crest, IL 60429-1442
Phone (708) 647-3333

Other identifiers 1

IdentifierTypeStateIssuer
19935OtherILILLINOIS CERTIFICATION BOARD INCORPARATED

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
19935ILMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1932563756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 CHEKER SQ",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291442",
            "telephone_number": "708-647-3333",
            "fax_number": "708-922-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 CHEKER SQ",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291442",
            "telephone_number": "708-647-3333",
            "fax_number": "708-922-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "TARA",
        "name_suffix": "I",
        "credential": "19935",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "19935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS CERTIFICATION BOARD INCORPARATED",
            "identifier": "19935",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.