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NPI Code Detail

MEDICARE: SEMILLAS COUNSELING PLLC

MEDICARE: SEMILLAS COUNSELING PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180010064IL

General Provider Information

NPI Number : 1003278938
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEMILLAS COUNSELING PLLC
Provider Business Mailing Address
First Line : 4001 N WOLCOTT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2411
Country : US
Telephone Number : 773-789-9775
Fax Number : 312-661-5235
Provider Business Practice Location Address
First Line : 4001 N WOLCOTT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2411
Country : US
Telephone Number : 773-789-9775
Fax Number : 312-661-5235
Authorized Official
Title or Position : OWNER
Name : MICHAEL VILLARREAL
Credential :
Telephone Number : 773-789-9775
Provider Enumeration Date : 03/21/2016
Last Update Date : 05/03/2024

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