Ivana Koralija

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4419 W North Ave
Melrose Park, IL 60160-1021

Phone

(773) 777-7112

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Youth Outreach Services

  • Community/Behavioral Health Agency
  • Melrose Park, IL
  • NPI 1568916476
  NPD (past)
• Youth Outreach Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Melrose Park, IL
  • NPI 1811227341
  NPD (past)

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1972229441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601021",
            "telephone_number": "773-777-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601021",
            "telephone_number": "773-777-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORALIJA",
        "first_name": "IVANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "yos.org",
            "affiliation": "N",
            "address_1": "4419 W North Ave",
            "city": "Melrose Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601601021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassadana Kirk, PA
• Jordan Richard Knudsen
• Keith Kolff, BA
• Mary Komperda, APN
• James F Koop, M.D.
• Shawanda Kornegay, BA
• Brittany Kosik
• Daniel J Koski, BA
• Rajani Kosuri, M.D.
• Krishna Chaitanya Kottapalli, MD

• Mental Health Counselor in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.