MR. KIRK REMON RIDDLE LICENSED PROFESSIONA
NPI 1205387990
Counselor - Professional in Chicago, IL

Q: What is Kirk Riddle's NPI number?

The NPI number for Kirk Riddle is 1205387990. It was assigned to this individual provider in the NPPES registry on October 18, 2016.

Q: What is Kirk Riddle's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Kirk Riddle was last updated on October 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since October 18, 2016PECOS Enrolled

1525 E. 53RD STREET, SUITE 425, CHICAGO, IL 60615(773) 819-5504 Get Directions Write a Review

NPPES record last updated: October 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Kirk Remon Riddle Licensed Professiona NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KIRK REMON RIDDLE LICENSED PROFESSIONA (NPI 1205387990) is an individual professional provider in Chicago, Illinois, licensed in Illinois (01YP2500X) and active in the NPI registry since October 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1205387990

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. KIRK REMON RIDDLECredential: LICENSED PROFESSIONA

Location Address1525 E. 53RD STREET, SUITE 425Chicago, IL 60615

Mailing Address8627 S. Wood StreetChicago, IL 60620 · (904) 502-3007

Phone(773) 819-5504

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateOctober 18, 2016

✔ NPI 1205387990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 01YP2500X

1525 E. 53RD STREET, SUITE 425, Chicago, IL 60615

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kirk Remon Riddle Licensed Professiona is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7416425608

PECOS Enrollment IDI20260506001514

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Kirk Riddle's NPI number?

The NPI number for Kirk Riddle is 1205387990. It was assigned to this individual provider in the NPPES registry on October 18, 2016.

Where is Kirk Riddle located?

Kirk Riddle practices at 1525 E. 53rd Street, Suite 425, Chicago, IL 60615. The listed phone number is (773) 819-5504.

What is Kirk Riddle's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kirk Riddle enrolled in Medicare?

Yes. Kirk Riddle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kirk Riddle was last updated on October 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.