Active NPI
Carly Ann Bosco
- Professional Counselor
- Park Ridge, IL
National Provider Identifier
1952931651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.015464
- Practice address
- 444 N Northwest Hwy
Park Ridge, IL 60068-3263 - Phone
- (630) 269-2886
- NPI assigned
- Jan 22, 2020
- 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 | 178.015464 | IL | Primary |
Addresses
Primary practice location
444 N Northwest Hwy
Park Ridge, IL 60068-3263
Mailing address
200 Shoreline Dr
Park Ridge, IL 60068-2934
Phone (847) 571-3175
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178.015464 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1952931651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SHORELINE DR",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600682934",
"telephone_number": "847-571-3175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 N NORTHWEST HWY",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600683263",
"telephone_number": "630-269-2886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCO",
"first_name": "CARLY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-22",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.015464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.