Healthcare Provider Details

I. General information

NPI: 1821411935
Provider Name (Legal Business Name): KEVIN BALL LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 LEE ST STE 920H
DES PLAINES IL
60016-4557
US

IV. Provider business mailing address

PO BOX 945
MORTON GROVE IL
60053-0945
US

V. Phone/Fax

Practice location:
  • Phone: 847-322-6695
  • Fax:
Mailing address:
  • Phone: 847-322-6695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180005789
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22330
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: