AV360 LLC — NPI 1013515501 (Certified Health Education Specialist (CHES / Preventive Patient Education) in ALGONQUIN, IL)

CMS-1500 Box 24J / 33a • NPI

1013515501

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

174H00000X (CMS D1)

Certified Health Education Specialist (CHES / Preventive Patient Education)

Box 32 Service Location & ZIP+4

2140 LAKE COOK RD, ALGONQUIN, IL, 60102-5447

✓ 9-Digit EDI 837 ZIP+4 (60102-5447)

Practice Phone & Referral Fax

(224) 333-0948

Fax: (224) 228-2822

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1013515501 (AV360 LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1013515501` (NPI-2 Organization / Facility)
Provider / Legal Name	AV360 LLC
Plain-English Specialty	Certified Health Education Specialist (CHES / Preventive Patient Education) NUCC Code: `174H00000X` (Health Educator)
Certifying / Licensing Body	National Commission for Health Education Credentialing (NCHEC)
Practice Location Address	2140 LAKE COOK RD, ALGONQUIN, IL, 60102-5447
Practice Telephone / Fax	Tel: (224) 333-0948 \| Fax: (224) 228-2822
Administrative Mailing Address	2140 LAKE COOK RD, ALGONQUIN, IL, 60102-5447
Enumeration & Last Sync	Enumerated: 2020-10-15 \| CMS Record Updated: 2022-01-11
Authorized Official	BETSY KOSTKA (Director of Operations)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2140 LAKE COOK RD, ALGONQUIN, IL, 60102-5447

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Plain-English Taxonomy & CMS Crosswalk (174H00000X)

What Does Taxonomy Code 174H00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 174H00000X translates to:
"Certified Health Education Specialist (CHES / Preventive Patient Education)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code D1 (Medicare Diabetes Preventive Program)
Certifying / Accrediting Authority: National Commission for Health Education Credentialing (NCHEC)
Clinical Scope: Structured lifestyle coaching for prediabetes, BMI and fatty liver reversal, maternal breastfeeding support, and preventive health literacy.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AV360 LLC)

Typical CPT / Diagnostic Procedures:

Diabetes Self-Management Education and Support (DSMES — CPT G0108/G0109)
Medical Nutrition & Cardiometabolic Lifestyle Counseling
Visual Hospital OPD Health Literacy & Preventive Screening Workshops

Common Therapeutic Classes:

Preventive Nutritional, Micronutrient & Oral Rehydration Education Protocols

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`251B00000X` — Case Management Plain English: Licensed & Credentialed Case Management	State: N/A \| License: `Verified` \| Primary: Secondary
`251S00000X` — Community/Behavioral Health Plain English: Licensed & Credentialed Community/Behavioral Health	State: N/A \| License: `Verified` \| Primary: Secondary
`174H00000X` — Health Educator Plain English: Certified Health Education Specialist (CHES / Preventive Patient Education)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AV360 LLC (NPI #1013515501)