POLLY MARIE VAUGHN
NPI 1750754008
Counselor - Professional in Bourbonnais, IL

NPI Status: Active since November 09, 2015

Contact Information

206 CHESTERFIELD CT
BOURBONNAIS, IL
ZIP 60914
Phone: (815) 603-2425

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  • Individual
  • Female
  • Years of Experience 19
  • Counselor
  • Professional
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About POLLY VAUGHN

This page provides the complete NPI Profile along with additional information for Polly Vaughn, a provider established in Bourbonnais, Illinois with a medical specialization in Counselor, focusing in professional and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1750754008 assigned on November 2015. The practitioner's primary taxonomy code is 101YP2500X with license number 180009894 (IL). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1750754008
Provider Name
POLLY MARIE VAUGHN
Gender
Female
Entity Type
Individual
Location Address
206 CHESTERFIELD CT BOURBONNAIS, IL 60914
Location Phone
(815) 603-2425
Mailing Address
PO BOX 2199 KANKAKEE, IL 60901
Mailing Phone
(815) 603-2425
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
Yes
Enumeration Date
11-09-2015
Last Update Date
06-07-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
180009894
License State
IL

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Central Bronze - HMO
  • Central Bronze + Vision + Adult Dental - HMO
  • Central Gold - HMO
  • Central Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? 901 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
  • Connect Bronze 2000 Indiv Med Deductible - HMO
  • Connect Bronze 5000 Indiv Med Deductible - Rx Copay - HMO
  • Connect Bronze CMS Standard - HMO
  • Connect Gold CMS Standard - Rx Copay - HMO
  • Connect Silver 3000 Indiv Med Deductible - Rx Copay - HMO
  • Connect Silver CMS Standard - HMO
  • UHC Bronze Copay Focus (No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Value (Rx Copay, No Referrals) - HMO
  • UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage (No Referrals) - HMO
  • UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus (No Referrals) - HMO
  • UHC Gold Standard (Rx Copay, No Referrals) - HMO
  • UHC Silver Advantage (Rx Copay, No Referrals) - HMO
  • UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Polly Vaughn is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Polly Vaughn is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7517307846

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250425000274

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750754008
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27100145800
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 4 + 5 + 8 + 0 + 0 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1750754008 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083152920INSTITUTE FOR SOCIAL AND EMOTIONAL LEARNING
Organization
Counselor (Mental Health)206 CHESTERFIELD CT
BOURBONNAIS, IL 60914
(815) 603-2425

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750754008, enumerated in the NPI registry as an "individual" on November 09, 2015

The provider is located at 206 Chesterfield Ct Bourbonnais, Il 60914 and the phone number is (815) 603-2425

The provider's speciality is Counselor with taxonomy code 101YP2500X with a focus in Professional

The provider has more than 19 years of experience.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

This NPI record was last updated on November 09, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.