Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kaileen Banaszak Gaumer

Individual provider Professional Counselor · NPI 1093402984

Kaileen Banaszak Gaumer is a Mental Health Counselor in Dixon, Illinois. Qualified in 2007, 19 years ago. Practices with Vitae Health Medical Illinois, PLLC, a 215-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2023

Practice location Address checks out

629 N Galena Ave Ste 120
Dixon, IL 61021-1664
Phone: (815) 288-1235
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178.005831 (IL)

Record details

NPI number1093402984
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 20, 2023
Last updated in NPPESApril 20, 2023
Certification dateApril 20, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Vitae Health Medical Illinois, Pllc — 215 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Dixon