MR. KENNETH LOUIS DALLA COSTA (NPI# 1265735120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265735120 |
| Entity Type | Individual |
| Full Name | MR. KENNETH LOUIS DALLA COSTA |
| Credential | LCPC |
| Practice Address |
15363 Tulip Ct Orland Park IL 60462-5024 |
| Mailing Address |
13701 Lauerman St 38 Cedar Lake IN 46303-9292 |
| Practice Telephone | 8477729289 |
| Mailing Telephone | 8477729289 |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2019-05-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180005602 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13701 Lauerman St, Cedar Lake, IN 463039292 | (847) 772-9289 |
| Street Address |
15363 TULIP CT |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60462-5024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083257331 | Stephanie Slager | Behavioral Analyst | 8430 W 135th St., Orland Park, IL 60462 | 2019-10-18 |
| 1730652587 | Nancy Lynch | Speech-Language Pathologist | 15100 S 94th Ave Orland School District 135, Orlond Park, IL 60462 | 2019-01-04 |
| 1932681327 | Alyssa Avant | Speech-Language Pathologist | 8851 W 151st St, Orland Park, IL 60462 | 2018-08-31 |
| 1922588110 | Pain Specialists of Greater Chicago S C | Pain Medicine | 15300 West Ave Ste C213, Orland Park, IL 60462 | 2018-08-16 |
| 1689168478 | S- R&r Counseling Inc. | Counselor | 9750 Crescent Park Cir Unit 306, Orland Park, IL 60462 | 2018-06-15 |
| 1104372952 | Amy Blanks | Nurse Anesthetist, Certified Registered | 13959 95th Avenue, Orland Park, IL 60462 | 2016-08-31 |
| 1740632454 | Anna S Wang | Optometrist | 14494 John Humphrey Dr, Orland Park, IL 60462 | 2016-07-06 |
| 1750739793 | Carolyn Sluis | Pharmacist | 9352 W 159th Street, Orland Park, IL 60462 | 2016-06-01 |
| 1164882262 | Caring Hands Group Home of Il, Inc. | Community/Behavioral Health | 14475 John Humphrey Dr., Orland Park, IL 60462 | 2016-03-02 |
| 1639539760 | Frazierworks Community Care, Inc. | In Home Supportive Care | 14475 John Humphrey Dr Suite 300, Orland Park, IL 60462 | 2016-03-02 |
| Find all providers in zip 60462 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689147993 | Karen T Butler-cook | Counselor | 9031 W 151st St Ste 102, Orland Park, IL 60462-6562 | 2019-01-09 |
| 1699261263 | Daniel B Santangelo | Counselor | 11512 183rd Pl Ste Ne, Orland Park, IL 60467-9499 | 2018-07-07 |
| 1821588310 | Marko Sipka | Counselor | 9641 W 153rd St Ste 48, Orland Park, IL 60462-3777 | 2018-05-10 |
| 1548654635 | Kasia Budyn | Counselor | 15127 S 73rd Ave Ste C, Orland Park, IL 60462-3463 | 2015-03-26 |
| 1184041840 | Dana Hall | Counselor | 11309 Distinctive Dr # 11309, Orland Park, IL 60467-9490 | 2014-03-19 |
| 1992145742 | Mona M Mason | Counselor | 14475 John Humphrey Drive, Suite C, Orland Park, IL 60462 | 2013-06-26 |
| 1366729584 | Nancy L Bonnevier | Counselor | 9153 Fairmont Ct, Orland Park, IL 60462-6524 | 2011-11-16 |
| 1033424346 | Marie Suzanne Doctor | Counselor | 15127 S. 73rd Ave, Suite G, Orland Park, IL 60462-4398 | 2010-08-11 |
| 1720315955 | Terri Eakins | Counselor | 15641 114th Ave, Orland Park, IL 60467-4476 | 2009-11-09 |
| 1295984516 | Kathy J De Vries | Counselor | 9721 W 165th St, Suite 23, Orland Park, IL 60467-4511 | 2008-09-10 |
| Find all providers in ORLAND PARK | ||||
| City | ORLAND PARK |
| Zip Code | 60462 |
Please comment or provide details below to improve the information on MR. KENNETH LOUIS DALLA COSTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.