Nancy D Bourke
Individual provider Active NPI Professional Counselor · Fox Lake, IL
NPI 1992330278 · NPPES record last updated Mar 7, 2020
Key facts
- NPI
- 1992330278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.014635 (IL)
- Practice address
- 34 W Grand Ave
Fox Lake, IL 60020-1224 - Phone
- (847) 322-2975
- NPI assigned
- Mar 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.014635 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheffer Psychological Services, PLLC | Current |
Accepting new patients |
Locations
34 W Grand Ave
Ste 101
Fox Lake, IL 60020
Phone (847) 322-3975
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.014635 | IL | Yes |
Addresses
Primary practice location
34 W Grand Ave
Fox Lake, IL 60020-1224
Mailing address
34 W Grand Ave
Fox Lake, IL 60020-1224
Phone (847) 322-2975
Other providers in Fox Lake, IL
- Bailey Behavioral Health, PLLC
- Diane M Bailey Yoder
- Maria Bernal
- Alexander J Blasco-Reyes
- Bonnie Mitchell Health Services
- Ashley Brown
- Jacob Brown
- Holly Kathleen Buchanan
- CD&L Dental Associates, Inc.
- Ningyu Chen
All providers in Fox Lake, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.