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MR. DEREK ROBERT CONN
NPI 1578826632
Counselor - Mental Health in Chicago, IL

Active since June 22, 2012PECOS Enrolled
5801 N PULASKI RD, CHICAGO, IL 60646(312) 744-1906 Get Directions Write a Review

NPPES record last updated: September 21, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Derek Robert Conn NPPES

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

MR. DEREK ROBERT CONN (NPI 1578826632) is an individual mental health provider in Chicago, Illinois and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1578826632
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. DEREK ROBERT CONN
Location Address5801 N PULASKI RDChicago, IL 60646-6007
Mailing Address611 Harris DrBuffalo Grove, IL 60089-1672 · (847) 275-3033
Phone(312) 744-1906
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 22, 2012
Last NPPES UpdateSeptember 21, 2012
✔ NPI 1578826632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5801 N PULASKI RD, Chicago, IL 60646
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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. Derek Robert Conn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668810177
PECOS Enrollment IDI20240403001514
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 10

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

MISS ANNIE SHEA NELSON
Counselor (Mental Health)
5801 N PULASKI RD, BUILDING C, 2ND FLOOR
CHICAGO, IL 60646
Cook County (312) 744-1906
LISA VINCENZINA SCANGA
Community/Behavioral Health
5801 N PULASKI RD, BUILDING C
CHICAGO, IL 60646
Cook County (312) 744-1906
MEL DAVID
Counselor (Mental Health)
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906
NORTHRIVER MHC
Public Health or Welfare
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906
NORTH RIVER MENTAL HEALTH CENTER
Clinic/Center (Mental Health (Including Community Mental Health Center))
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906
CITY OF CHICAGO: NORTH RIVER BEHAVIORAL HEALTH CENTER
Community/Behavioral Health
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906
KATY KRYSTYNIAK
Counselor
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906
CITY OF CHICAGO DEP. OF PUBLIC HEALTH
Community/Behavioral Health
5801 N PULASKI RD
CHICAGO, IL 60646
Cook County (312) 744-1906

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 Derek Conn's NPI number?

The NPI number for Derek Conn is 1578826632. It was assigned to this individual provider in the NPPES registry on June 22, 2012.

Where is Derek Conn located?

Derek Conn practices at 5801 N Pulaski Rd, Chicago, IL 60646. The listed phone number is (312) 744-1906.

What is Derek Conn's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Derek Conn enrolled in Medicare?

Yes. Derek Conn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derek Conn was last updated on September 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.