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

Wanda Diderich

Individual provider Professional Counselor · NPI 1396259081

Wanda Diderich is a Mental Health Counselor in Rockford, Illinois. Qualified in 2017, 9 years ago. Practices with Beloit Health System Inc, a 141-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
9
Licensed in
IL
In the registry since
2017
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Practice location Address checks out

8616 Northern Ave
Rockford, IL 61107-5309
Phone: (815) 332-8003
Fax: (815) 332-6090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 178013374 (IL)

Record details

NPI number1396259081
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 17, 2017
Last updated in NPPESNovember 17, 2017
Mailing address1021 N Mulford Rd, Rockford, IL 61107-3877

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Beloit Health System Inc — 141 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Rockford