Address: 4055 W Peterson Ave Ste 202, Chicago, IL 60646-6183

ALLYSSA ROSE BERTRAM (NPI# 1366058075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366058075
Entity Type Individual
Gender Female
Credential LCPC CADC
Practice Address 4055 W Peterson Ave Ste 202
IL 60646-6183
Practice Telephone 7737744444
Mailing Address 702 Dempster St Apt E105
Mount Prospect
IL 60056-6154
Mailing Telephone 4404525245
Certification Date 2020-09-17
Enumeration Date 2020-09-17
Last Update Date 2020-09-17
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 101Y00000X Counselor 193400000X SINGLE SPECIALTY GROUP 180.012157 IL Behavioral Health & Social Service Providers

Other Provider Identifiers

Identifier State Issuer Type Code
180.012157 IL LCPC Other

Associated Endpoints

Endpoint Type Endpoint Affiliation Affiliation Address Use Content
Direct Messaging Address (work email) 4055 W Peterson Ave Ste 202, Chicago, IL 606466183 Direct CSV

Office Location

Street Address 4055 W PETERSON AVE STE 202
State IL
Zip Code 60646-6183

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730656000 Embodied Change, Inc Community/Behavioral Health 4055 W Peterson Ave Ste 104, Chicago, IL 60646-6183 2018-10-25

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1003157298 Family Choice Home Health · Family Choice Homemaker 5933 N Milwaukee Avenue, Chicago, IL 60646 2013-03-13
1033421482 Hellenic Foundation Community/Behavioral Health 6251-53 W. Touhy Avenue, Chicago, IL 60646 2010-07-13
1801312087 Manal Ibrahim Dentist 6228 N Keystone Ave, Chicago, IL 60646 2017-08-18
1538304167 Life Options Health Services, Inc Home Health 4001 W. Devon Ave, Suite 409, Chicago, IL 60646 2008-12-11
1922334200 Abridge Homecare Services Home Health 4744 W Peterson, Chicago, IL 60646 2009-10-21
1164889754 Physicians At Call Family Medicine 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 2016-01-27
1780812636 Nicole A. Cissell Behavioral Analyst 4801 W. Peterson Avenue, Suite 512, Chicago, IL 60646 2009-06-30
1487191151 Ronald E. Rysztogi Naprapath 5704 N. Austin, Chicago, IL 60646 2017-01-19
1063783702 Eleni Kozonis-Konstantinou Dentist 5868 N. Milwaukee Ave., Chicago, IL 60646 2012-01-25
1275709628 George Milanez Dentist - General Practice 6134 N Milwaukee Ave, Suite A, Chicago, IL 60646 2008-05-06
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447820766 Nicole Glass Counselor 420 E Ohio St Apt 14c, Chicago, IL 60611-4651 2021-06-29
1093385569 Keila Pope Counselor 3708 N Ashland Ave, Chicago, IL 60613-5272 2021-06-28
1790352888 Rebecca Ebben Counselor 1616 N Damen Ave Ste 301, Chicago, IL 60647-5536 2021-06-07
1912573494 Elizabeth Quinn Davis Counselor 155 N Michigan Ave Ste 444, Chicago, IL 60601-7511 2021-06-03
1285209098 Charlene Mack Counselor 47 W Division St Ste 211, Chicago, IL 60610-2954 2021-05-24
1033793757 Traci Patterson Lcpc Cadc Pllc · Intuitive Therapy Chicago Counselor 203 N La Salle St Ste 2100, Chicago, IL 60601-1226 2021-05-09
1013590215 Falechia N Turman Counselor 5080 N Elston Ave, Chicago, IL 60630-2459 2021-05-04
1538741780 Jameelah Brown-Williams Counselor 2500 W 111th St Apt 1s, Chicago, IL 60655-1301 2021-04-27
1457937542 Jamila Ford Counselor 5425 W Van Buren St, Chicago, IL 60644-4745 2021-03-20
1124603857 Liana Ramon Counselor 1525 E 53rd St Ste 1009, Chicago, IL 60615-4547 2021-03-15
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Dataset Information

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.