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WANDA DIDERICH
NPI 1396259081
Counselor - Professional in Rockford, IL

Active since November 17, 2017PECOS EnrolledAccepts Medicare Assignment
8616 NORTHERN AVE, ROCKFORD, IL 61107(815) 332-8003(815) 332-6090 Get Directions Write a Review

NPPES record last updated: November 17, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wanda Diderich NPPES

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

WANDA DIDERICH (NPI 1396259081) is an individual professional provider in Rockford, Illinois, licensed in Illinois (178013374) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1396259081
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameWANDA DIDERICH
Location Address8616 NORTHERN AVERockford, IL 61107-5309
Mailing Address1021 N Mulford RdRockford, IL 61107-3877 · (815) 387-5600 · Fax (815) 316-4726
Phone(815) 332-8003
Fax(815) 332-6090
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 17, 2017
✔ NPI 1396259081 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 · 178013374
8616 NORTHERN AVE, Rockford, IL 61107
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Other Identifiers 1

Other17013374IL · Lpc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW, Quartz.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Wanda Diderich 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.

PECOS PAC ID7012356967
PECOS Enrollment IDI20241119004639
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY BRUN
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
MR. JACOB R WILSON BA
Counselor (Mental Health)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 391-1000
SEAN WALSH LPC
Counselor (Professional)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
DEBRA CORRIGAN APN
Nurse Practitioner (Psychiatric/Mental Health)
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 399-9700
JACQUELINE BELTER
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
ALICIA ANDERSON L.S.W.
Social Worker
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 338-8003
CHRISTINA ADAMS
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003
MELISSA LEE
Counselor
8616 NORTHERN AVE
ROCKFORD, IL 61107
Winnebago County (815) 332-8003

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 Wanda Diderich's NPI number?

The NPI number for Wanda Diderich is 1396259081. It was assigned to this individual provider in the NPPES registry on November 17, 2017.

Where is Wanda Diderich located?

Wanda Diderich practices at 8616 Northern Ave, Rockford, IL 61107. The listed phone number is (815) 332-8003.

What is Wanda Diderich's specialty?

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

Is Wanda Diderich enrolled in Medicare?

Yes. Wanda Diderich 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.

What insurance does Wanda Diderich accept?

Health plans from Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW and Quartz list Wanda Diderich 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 Wanda Diderich was last updated on November 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.