MR. SERGIO AYALA (NPI# 1619535002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619535002 |
| Entity Type | Individual |
| Full Name | MR. SERGIO AYALA |
| Credential | M.DIV., M.S., LMHC |
| Practice Address |
7601 S Kostner Ave Chicago IL 60652-1126 |
| Mailing Address |
606 141st St Hammond IN 46327-1221 |
| Practice Telephone | 6309361839 |
| Mailing Telephone | 6309361839 |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2019-05-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
33810 | IL | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
094835 | IA | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
178.010795 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780916163 | Sergio Ayala | Dentist | 964 Leslie Rd, El Cajon, CA 92020-6285 | 2010-02-09 |
| 1053895888 | Sergio Gabriel Ayala | Behavior Technician | 300 Los Altos Pkwy Ste 109, Sparks, NV 89436-7754 | 2018-09-18 |
| Street Address |
7601 S KOSTNER AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60652-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407808371 | Kathy J Webb | Occupational Therapist | 7601 S Kostner Ave, Suite 150, Chicago, IL 60652-1126 | 2006-05-17 |
| 1104325448 | Curtis Lee Slate | Counselor | 7601 S Kostner Ave, Chicago, IL 60652-1126 | 2018-02-01 |
| 1407392160 | Khalil Foundation | Community/Behavioral Health | 7601 S Kostner Ave, Suite 206, Chicago, IL 60652-1126 | 2017-01-18 |
| 1053776799 | Lutheran Child and Family Services of Illinois | Foster Care Agency | 7601 S Kostner Ave, Suite 308, Chicago, IL 60652-1126 | 2015-12-23 |
| 1669844627 | Leodis F Scott Sr. | Counselor | 7601 S Kostner Ave, Chicago, IL 60652-1126 | 2015-10-29 |
| 1407042591 | Maria L. Reyes, M.d., S.c. | Pediatrics | 7601 S Kostner Ave, Suite 209, Chicago, IL 60652-1126 | 2007-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861042715 | New Hope Community Service Center | Clinic/Center | New Hope Community Service Center, 2559 West 79th, Chicago, IL 60652 | 2019-09-12 |
| 1770012189 | Rachel Pasternak | Social Worker | 3348 W 87th Street, Chicago, IL 60652 | 2017-06-08 |
| 1437682283 | Manliu Yang | Dentist | 8541 S Cicero Ave, Chicago, IL 60652 | 2017-04-08 |
| 1336687144 | Stephanie J. Wilson | Registered Nurse | 7600 S. Pulask Rd., Chicago, IL 60652 | 2017-02-01 |
| 1346786811 | Talisha Moman | Licensed Practical Nurse | 7600 S. Pulaski Rd., Suite 1106, Chicago, IL 60652 | 2017-01-09 |
| 1952851933 | Yvonne Caldwell | Licensed Practical Nurse | 8600 S. Pulaski, Road, Chicago, IL 60652 | 2016-10-13 |
| 1942605795 | Brittney Mclean | Developmental Therapist | 4317 W. 77th Pl, Chicago, IL 60652 | 2014-10-22 |
| 1245599521 | Chisa Marie Collins | Occupational Therapist | 8008 S Albany, Chicago, IL 60652 | 2012-05-08 |
| 1548572969 | St. Mary Therapy Services | Clinic/Center | 2455 W 79th St, #101, Chicago, IL 60652 | 2010-07-14 |
| 1750574752 | Curt R Lang | Dentist | 4651 W 79th St, Suite 208, Chicago, IL 60652 | 2007-08-22 |
| Find all providers in zip 60652 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780602 | Saba Aqel | Counselor | 107 W Van Buren St Ste 215, Chicago, IL 60605-1054 | 2020-11-05 |
| 1538768155 | Angelicare LLC | Counselor | 6650 N Northwest Hwy Ste 215, Chicago, IL 60631-1363 | 2020-10-23 |
| 1013516145 | Modern Soul Therapy LLC | Counselor | 2000 N Racine Ave Ste 2160, Chicago, IL 60614-4045 | 2020-10-20 |
| 1477151942 | Mansukh Sandhu | Counselor | 8765 W Higgins Rd Ste 450, Chicago, IL 60631-4172 | 2020-10-15 |
| 1881291920 | Freddy Reyes | Counselor | 931 W Leland Ave Apt 405, Chicago, IL 60640-6611 | 2020-10-01 |
| 1508463704 | Tynisha Jointer | Counselor | 7710 S Saint Lawrence Ave, Chicago, IL 60619-2925 | 2020-10-01 |
| 1851908206 | Manqual Chambers | Counselor | 2801 S King Dr, Chicago, IL 60616-2949 | 2020-09-29 |
| 1184231672 | Francesca Cottone | Counselor | 1616 N Nordica Ave, Chicago, IL 60707-4317 | 2020-09-28 |
| 1952916322 | Elle Skelton | Counselor | 2219 N Seeley Ave Apt 3f, Chicago, IL 60647-3363 | 2020-09-13 |
| 1437764305 | Donita M Lester | Counselor | 7022 S South Shore Dr Apt 214, Chicago, IL 60649-2229 | 2020-09-09 |
| Find all providers in CHICAGO | ||||
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| 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.