Individual provider Active NPI

Kim T. Pronoitis, L.P.C.,N.C.C.

  • Professional Counselor
  • Tinley Park, IL
National Provider Identifier
1942517768
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.006811 Issued in IL
Practice address
16547 Oak Park Ave
Tinley Park, IL 60477-1752
Phone
(708) 633-9003
Fax
(708) 633-1823
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.006811 IL Primary

Addresses

Primary practice location

16547 Oak Park Ave
Tinley Park, IL 60477-1752

Mailing address

16547 Oak Park Ave
Tinley Park, IL 60477-1752
Phone (708) 633-9003

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
I20240229001165 IL Practitioner - Mental Health Counselor 7810332889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Christian Counseling Center IncGroup PAC ID 1052395258, 20 clinicians

Practice addresses (Care Compare)

15127 S 73Rd Ave
Suite G
Orland Park, IL 60462-3425
Phone (708) 845-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.006811ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Christian Counseling Center Inc Professional CurrentSince Jan 3, 2024 Accepting new patients
Southside Christian Counseling Center Professional Past Accepting new patients

Locations

15127 S 73rd Ave
Orland Park, IL 60462
Phone (708) 586-9608

15127 S 73rd Ave
Ste G
Orland Park, IL 60462
Phone (630) 990-1935

16107 La Salle St
South Holland, IL 60473

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1942517768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16547 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771752",
            "telephone_number": "708-633-9003",
            "fax_number": "708-633-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16547 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771752",
            "telephone_number": "708-633-9003",
            "fax_number": "708-633-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONOITIS",
        "first_name": "KIM",
        "middle_name": "T.",
        "credential": "L.P.C.,N.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.006811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.