Active NPI
Camillia Depke
- Professional Counselor
- Burr Ridge, IL
National Provider Identifier
1942483029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 7055 Veterans Blvd
Burr Ridge, IL 60527-5634 - Phone
- (630) 325-4899
- NPI assigned
- Dec 11, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
7055 Veterans Blvd
Burr Ridge, IL 60527-5634
Mailing address
7055 Veterans Blvd
Burr Ridge, IL 60527-5634
Phone (630) 325-4899
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240223003204 | IL | Practitioner - Mental Health Counselor | 6709221237 |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1440 W Taylor St
Chicago, IL 60607-4623
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197331200000",
"number": "1942483029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7055 VETERANS BLVD",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275634",
"telephone_number": "630-325-4899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7055 VETERANS BLVD",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605275634",
"telephone_number": "630-325-4899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEPKE",
"first_name": "CAMILLIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-11",
"last_updated": "2007-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.