Nicholas Spiros Sourbis

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1023 Burlington Ave
Western Springs, IL 60558-1516

Phone

(708) 745-5277

Fax

(708) 784-9451

NPI assigned

Mar 3, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Rodasi LLCGroup PAC ID 0749418630, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rodasi LLC

  • Mental Health Counselor
  • Hoffman Estates, IL
  • NPI 1467691790
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1942660949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 BURLINGTON AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581516",
            "telephone_number": "708-745-5277",
            "fax_number": "708-784-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 BURLINGTON AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581516",
            "telephone_number": "708-745-5277",
            "fax_number": "708-784-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURBIS",
        "first_name": "NICHOLAS",
        "middle_name": "SPIROS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas F Slowinski, D.C.
• Smiles for Life, PC
• Keith D. Smith
• Paul Smith, DPM
• Elliot Anna Snow, LMT, CLT
• Caitlin Southrey
• Speech and Language Academy, Inc.
• Frederick R Spencer, DPM
• Spring Orthodontics
• Springdale Eyecare LLC

• Counselor in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.

Verify at the official NPI Registry.