MR. THEODORE ERIC VOGEL-WILSON – Counselor, NPI 1639693849

MR. THEODORE ERIC VOGEL-WILSON is a healthcare provider. based in Rock island, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 107440 (IA). The NPI Number for MR. THEODORE ERIC VOGEL-WILSON is 1639693849

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
MR. THEODORE ERIC VOGEL-WILSON
NPI
1639693849
Phone
(309) 558-4063
Address
931 17TH ST
Enumeration Date
29 July 2017
Last Update Date
16 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5633594049
Graduation Year
2020 (6 years ago)
PAC ID
9537677471
Group Practice PAC ID
7810887452
Professional Enrollment ID
I20250802000076
Address ID
IA528071135DA2102XSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:8State licenses:2Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

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Provider Addresses for MR. THEODORE ERIC VOGEL-WILSON

  • 931 17TH ST

    ROCK ISLAND, IL 612012724

    Phone: (309) 558-4063

    Type: Mailing

  • 2200, 3rd Avenue, Rock Island, Rock Island County, Illinois, 61201, United States

    ROCK ISLAND, IL 612018840

    Phone: (309) 779-2094

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250802000076IMental Health CounselorIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7810887452View full group profile
NameSpecialtyState
Clinical Social WorkerIA
-IA
Clinical Social WorkerIA
Clinical PsychologistIA
Clinical Social WorkerIA
Clinical Social WorkerIL
-MO
Clinical PsychologistIA
Clinical PsychologistIA
-IA

Reviews

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Frequently asked questions

Can I use this page to confirm MR. THEODORE ERIC VOGEL-WILSON's NPI?
Yes. MR. THEODORE ERIC VOGEL-WILSON is listed with NPI 1639693849 in the public NPI dataset.
Is MR. THEODORE ERIC VOGEL-WILSON still practicing?
MR. THEODORE ERIC VOGEL-WILSON is currently listed as active in the public NPI registry.
What is MR. THEODORE ERIC VOGEL-WILSON's specialty?
The listing groups MR. THEODORE ERIC VOGEL-WILSON with Counselor. Clinical services aligned with this taxonomy classification.
What address line appears for MR. THEODORE ERIC VOGEL-WILSON?
MR. THEODORE ERIC VOGEL-WILSON's geographic hint is Rock Island, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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