KENNY CHAN LPC
NPI 1174121495
Counselor - Professional in Bloomingdale, IL
About Kenny Chan Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNY CHAN LPC (NPI 1174121495) is an individual professional provider in Bloomingdale, Illinois, licensed in Illinois (178016192) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenny Chan Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kenny Chan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Rockford, IL 61107
- Reassigned Medicare billing, Illinois enrollment
- Medicare enrollment name: Rockford Psychiatric Medical Services Sc
- 163 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BLOOMINGDALE, IL 60108
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenny Chan's NPI number?
The NPI number for Kenny Chan is 1174121495. It was assigned to this individual provider in the NPPES registry on October 9, 2020.
Where is Kenny Chan located?
Kenny Chan practices at 125 Fairfield Way Ste 380, Bloomingdale, IL 60108. The listed phone number is (815) 295-5470.
What is Kenny Chan's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kenny Chan enrolled in Medicare?
Yes. Kenny Chan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kenny Chan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenny Chan reassigns Medicare benefits to Rockford Psychiatric Medical Services, S.C. (Rockford, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenny Chan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kenny Chan accept?
Health plans from Anthem Blue Cross and Blue Shield, MercyCare, MercyCare Health Plans, Oscar Health and Quartz and 1 other insurer list Kenny Chan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kenny Chan was last updated on December 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kenny Chan, LPC · NPI 1174121495
Professional provider in Bloomingdale, Illinois. Individual provider, active in the CMS NPPES registry since October 9, 2020.
## Identity
- **NPI:** 1174121495 (Entity type: Individual)
- **Enumerated:** October 9, 2020
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 178016192 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 125 FAIRFIELD WAY STE 380, Bloomingdale, IL 60108-3701
- **Phone:** (815) 295-5470
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Rockford Psychiatric Medical Services, S.C. (NPI 1821391442, Rockford, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** December 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1174121495) · Data from the CMS NPPES public registry.